Role of social support on adherence to antiretroviral therapy among patients attending AMPATH clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Introduction: This study aimed at generating information on the level of adherence to Antiretroviral Therapy and the association between social support and adherence to ARVS among patients at the Academic Model for Providing Access to Health Care (AMPATH) clinic-Moi Teaching and Referral Hospital (MTRH) in Eldoret. Justification: Poor adherence to ARVs can cause harm. Adherence is said to be optimum if the patient takes all pills in the correctly prescribed doses, at the right time and in the right way for at least 95% of the time. Social support has been recommended as one of the strategies of intervention to improve adherence. Social support has been introduced in most of health facilities but its effects on adherence remain undocumented in Kenya, hence the need for this study. Objectives: 1. To estimate proportions of patients reporting optimum adherence to ARVs. 2. To identify the types of social support being utilized by AMPATH patients. 3. To determine the association between social support and adherence to ARVs Study Methods: This was a cross sectional study in which a total of 299 patients were interviewed and 12 In-depth interviews conducted with care providers working at the AMPATH clinic at MTRH. Data was collected between January and March 2010. Study results: The sample consisted of 108(36.1 %) males. The median age was 32 years (IQR 28-39). Optimum adherence was reported by 219(73.2%) of the participants. Those aged 25- 34 years were more likely to adhere compared to those aged below 25 years (Adjusted OR=3.36, 95% CI: 1.44 – 7.81, P = 0.005). Females were more likely to adhere (Adjusted OR=2.80, 95% CI: 1.45 – 5.38, P = 0.002). Most of the participants (184, 61.5%) reported to be members of support groups, 190(63.5%) reported to have disclosed their HIV status to their sexual partners and advice from health care providers was reported by all the participants. Reporting optimum adherence was positively associated with disclosure of HIV status to sexual partner (Adjusted OR= 2.43, 95% CI: 1.37 – 4.29 P value= 0.002), belonging to a support group (Adjusted OR=2.68, 95% CI: 1.51 – 4.76, P value = 0.001) and perceived support from children (Adjusted OR=2.90, 95% CI: 1.29 – 6.53, P value = 0.01). Conclusion & recommendation: Belonging to a support group, disclosure to partner and perceived support from children was positively associated with optimum adherence. Patients should be encouraged to join support groups and also disclose their status to their spouses to enhance support from these members of the family.