Knowledge, Attitude And Practice On Haart Adherence Among Female Sex Workers In Majengo And Swop Clinics

Abstract

Background: Current emphasis in HIV/ AIDS management programs is to provide universal access to ART to all those who meet the inclusion criteria. Adherence is a critical determinant of the efficacy of prescribed HIV medications but an objective measure of compliance still remains elusive. Adherence to ART treatment is a critical factor among those on therapy and especially among high frequency transmitter core groups such as sex workers and other most at risk populations who may spread resistant mviruses to their contacts. Objective: The purpose of the study was to determine knowledge, attitudes and practices towards the required perfect ART adherence protocols among female sex workers. Method: A cross-sectional study involving face to face exit interviews, two support/focus group discussion and abstracted data review on sex workers initiated on HAART was conducted. Face to face interviews data was collected using structured questionnaire with open and closed type questions where a total of 156 participants were interviewed. Collected data was analyzed using SPSS version 17. Descriptive statistics, univariate and multivariate analysis using logistic regression were performed. Results: The median adherence rate among FSW was 97.4 percent. There was a significant disparity between adherence reported during the face to face interviews with adherence rates recorded on the patient charts by the clinical team on the same date (p=0.002). Factors that were significantly associated with poor adherence in this study are similar to published reasons such as hard to remember to take medication (p= O. 05) were noted in addition to the influence of alcohol use (p=0.032). Conclusion: The observed median adherence rate to ART at 97.4 percent among sex workers in Nairobi is optimal and may be higher than in other comparable groups from the general population in other African and developing countries. The study recommends that the adherence rates should be maintained at the same level or higher through increasing investments in ART support group activities, membership and frequency of these meetings. Clinicians can use this information to engage in open discussion with patients to promote adherence and identify barriers and facilitators within their own population.