Abstract:

Background: HIV/AIDS has become a global burden such that a lot of effort has been made to counter the disease process and improve the quality of life of the affected individuals. Despite all these a growing trend has been observed of poor adherence to the anti-retro viral which highly affect the health and quality of life of these individuals. To tackle this problem, the enhanced adherence counselling program was set forth. The program takes in clients with poor adherence and are trained and monitored for three months. Amongst many things, the clients are taught the importance of proper adherence and the usually fatal outcomes to poor adherence whilst also covering and trying to eliminate the challenges causing the deviate in the adherence. This study was set out to assess the adherence to anti-retroviral amongst people living with HIV/AIDS after the enhanced adherence counselling program. The study specifically was assessing the adherence to medication, attitude and effectiveness of the enhance adherence counselling of people living with HIV/AIDS who use anti-retroviral in patients attending the Bugando Medical Centre continuous treatment clinic over the course of 2 years.

Objective of the study: The study objective included the assessment of the people living with HIV/AIDS after adherence counselling social demographic information their awareness and attitude towards the significance of anti-retroviral treatment.

Methodology: The study design was a cross sectional retrospective hospital study that took 3 months, done in Mwanza at Bugando Medical Centre. The study focused on adults above 18 years of age attending continuous treatment clinic in Bugando Medical Centre and have completed the enhanced counselling within 3 month to 2 years. A total of 200 clients were enrolled in the study serial convenient sampling during clinic visits.

Results: The magnitude of adherence to anti-retroviral post enhanced adherence counselling was assessed using pill count and self-assessment tool as one means and the other being CD4 count. The two means of adherence assessment average to 93.5% of the participants having good adherence and 6.5% of the participants having poor adherence. Adherence assessment using CD4 count showed most clients had significantly high CD4 count on the initiation of anti-retroviral which had significantly by the time of initiation of the enhanced adherence counselling program. This then showed a complete turnaround after the completion of the program where more than 90% of the clients CD4 count had risen. Assessment for factors affecting adherence was also done where a total of 10 factors were assessed before the initiation of the enhanced adherence counselling program and later reassessed before the initiation of the enhanced adherence counselling, 4 factors were alcohol use, distance from the clinic, time to reach the clinic and stigma which together amounted to almost half the percentage of all factors affecting adherence amongst the clients. After the completion of the enhanced adherence counselling program these factors were reassessed and showed a significant drop in effectiveness such that only 16% of the clients still had factors that affected their adherence to ARVs. The remaining 84% no longer had any factors which affected their adherence to medication. This then proved the affectivity of the enhanced adherence counselling program.

Conclusion: The finding of this study show good levels of adherence to ARVs among clients who attended EAC at BMC CTC which is a treatment to the efficiency of the EAC program. It also indicated age and the marital status of the participants as the factors affecting the adherence to ARVs even after the EAC program.