Psychosocial factors associated with antiretroviral therapy adherence among HIV positive partners in discordant relationships

Abstract

Introduction ; The HIV discordant sexual partners in stable relationships account for 5 % of all couples in Kenya (KAIS , 2012). New HIV infections have been noted to be highest among this segment of the community. Recent findi ngs have demonstrated that use of ARVs by an infected partner can lower chances of HIV transmission by 96% to their uninfected partner(Kathy Stover 2011). For drugs to work they must be taken as instructed, poor adherence is a major cause of suboptimal res ponse to medication. This research explored psychosocial factors associated with adherence to ARVs among infected partners in discordant relationships in Thika district . Methodology: The study utilized cross sectional descriptive design . Adherence was asse ssed using a questionnaire to collect quantitative data and a focus group discussion guide was designed and used for collection of qualitative data . Results: Findings revealed an adherence level of 91.89 % among the 2 22 respondents. Motivators to adherence reported included belief in treatment efficacy (97.17%) and social support ( 74% p=0.003) . Risk factors associated with non - adherence included lack of transport ( 20% ) , forgetting to take medication and illness ( 16.7% ) and fa mily and marital conflict ( 12.5% ) . Psychiatric morbidity observed among the participants included depress ive symptoms ( 18.3% ) ( p – value 0.002. Alcohol use ( 22.5% ) and other psychoactive drugs like tobacco at 18.8 %. Intimate partner violence and risky sexual behavior were al so risk facto rs for non - adherence at p=0.028 and p< 0.00 5 respectively. Recommendations: The study pro poses putting in place interventions aimed at addressing social economic conditions, intimate partner violence, and treatment of psychiatric illness so as to address the sub optimal levels of adherence.