ISSN 2326-7291
International Journal of Public Health and Epidemiology ISSN: 2326-7291 Vol. 3 (3), pp. 017-025, March, 2014. © International Scholars Journals
Full Length Research Paper
Self-reported adherence to antiretroviral therapy in sub-Saharan Africa: A meta-analysis
*1Charles E. Okafor and 1Obinna I. Ekwunife
*1Department of Pharmacy, National Orthopedic Hospital, Enugu. PMB 01294, Nigeria.
1Mopheth Pharmacy, Lagos Nigeria.
*Corresponding Authors. Email: [email protected]
Accepted 02 October, 2013
Abstract
As treatment of HIV infection with antiretroviral medications becomes a reality in sub-Saharan Africa, adherence to treatment regimen becomes a challenge. A meta-analysis was conducted to summarize the reported adherence rate in sub-Saharan Africa. Forest plot was used to visualize the extent of heterogeneity among studies. Following the random effect model, the combined adherence percent was 84.31% (95% CI = 79.48% - 88.60%). The Monte Carlo sensitivity analysis provided an alternative statistical method to evaluate pooled proportion and the analysis was similar to the random effect analysis. Identified barriers to adherence include: depression, centralized ART clinic, interruption in drug supply/procurement, stigma, absence of social support, cost of ART, complacency, forgetfulness and medication related problems. Cost of ART (OR = 2.19; 95% CI= 1.65 – 2.90), Complacency (OR = 5.25; 95% CI = 2.89 – 10.80), and medication related problems (OR = 1.68; 95%CI = 1.28 – 2.22) were the strongest barriers to adherence. This study showed a good level of adherence in sub-Saharan Africa. However, barriers to adherence identified in this study could be employed to improve adherence to a near perfect level.
Key words: Adherence, antiretroviral, Sub-Saharan Africa, HIV/AIDS, self-reported, meta-analysis.