Association between self-reported medication adherence and virologic outcome among human immuno-deficiency virus positive adults accessing care at a tertiary treatment centre in Rivers State, Nigeria

Abstract

Medication adherence reduces the risk of resistance to antiretroviral therapy. The frequently applied methods in measuring medication adherence are self-reported adherence and viral load monitoring. However, due to the backdrop of recall bias and overestimation of outcomes associated with self-reported adherence, viral load monitoring may be a better measure. This study assessed the association between medication adherence and virologic outcome among human immuno-deficiency virus (HIV) positive adults accessing care at a treatment centre in Rivers State, Nigeria. This cross-sectional study employed the systematic sampling technique to select eligible HIV-positive adults accessing care at the University of Port Harcourt Teaching Hospital between September 2022 to November 2022. Data were collected using a validated 3-item structured interviewer-administered questionnaire and analyzed with statistical package for social science (SPSS) version-26. Pearson’s Chi-square was used to test for associations at a significance level of p<0.05 and a 95% confidence interval. Confounding variables were controlled by stratifying into gender groups. 1600 participants were recruited; males (800), and females (800) with a mean age and standard deviation; males (44.53±10.50), and females (40.58±9.34). The mean self-reported optimal adherence levels were; male (98.7±6.4), and female (97.3±10.0) at p<0.001. The virologic suppression levels were; male (89.5%), and female (89.6%). The association between self-reported adherence and virologic outcome; female (90.0%, p=0.268) and male group (89.7%, p=0.485). Self-reported adherence was not associated with virologic outcomes between gender groups. Hence, viral load monitoring is recommended as a standalone method of assessing medication adherence due to its additional advantage of measuring progress toward virologic suppression.