A study to Assess the Factors Affecting Compliance of art among HIV Patients at Selected Artcenters of Pune city

 

Ganesh Lal Patidar

Asst. Professor, Joitiba College of Nursing, Bhandu, Tal- Visnagar, Dist- Mehsana (Gujarat)

 

ABSTRACT:

Background-Human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS), was first recognized on 1^st December 1981 and has since become one of the most destructive pandemics in recorded history. In India the first AIDS case was reported in May 1986 in Madras, South India. There are 5.7 million people infected with HIV. By 2015 India has the world's fourth largest population suffering from AIDS. ART increases the length, quality of life, and productivity of the people living with HIV (PLWH) by improving survival and decreasing the incidence of opportunistic infections through reduction of the viral load and increase of the level of CD4 cells .The effectiveness of ART relies on a strict adherence to it.⁶In 2014, 14.9 million people living with HIV were receiving antiretroviral therapy (ART) globally, of which 13.5 million were receiving ART in low- and middle-income countries. The 14.9 million people on ART represent 40% [37–45%] of people living with HIV globally^1. According to the census done by ART center of District Wenlock hospital, Mangalore, Dakshina Kannada in December 2012, revealed that out of 3,836 cases, only 2,218 patients were on regular ART, 126 belonged to the 'stopped treatment' status, and 117 patients were lost to follow-up from the last three months.².  Aims and Objectives-(1)To identify the factors affecting compliance of ART treatment of HIV among HIV patients.(2)To find out the association between factors affecting compliance of ART with selected demographic variable. Material and Methods­- Data was collected from 100 patients with structured questionnaire to assess the factors affecting compliance of ART. And interview schedule technique was used. Result- Majority of the patients with HIV In the study 53% of the patients was males. And the maximum 33% of them was from age group 31-40 years. And Maximum 38% of them had primary education. The majority of the samples 32% of them was housewives. And 84% of them had caregivers as family members. The findings of the study were 73% patients believe in ART, 72% aware about ART, 79% manage daily routine with ART,69% believe that ART increase life span.92% family member know the diagnosis of patient and 74% behave well with them,92% disclosed diagnosis in society and 31% behave good after knowing diagnosis, 75% stigma affect, 74%respond that special consideration given for ART where they doing job,89% patient said cost of transportation affect and 52% family members support for finances. 91% said counselor cooperate with them, 62% have time to Attend OPD, 78% said counselor maintain good relation with them, and only 55% said counseling was effective for them. And 77% patient knows the side effects of ART and 71% experience the side effect, 49% patient said side effect of ART has impact in regularity of treatment, 58% patient said other medicine affects in compliance to ART. Conclusion-The overall experience of conducting this study was satisfying one, as there was good co-operation from patient. The study was a new learning experience for the Researcher. The aim of the study was to assess the factors affecting to compliance of antiretroviral treatment, were 73% patients believe in ART, 72% aware about ART, 69% believe that ART increase life span. 75% stigma affect, 74%respond that special consideration given for ART where they doing job,89% patient said cost of transportation affect 71% experience the side effect, 49% patient said side effect of ART has impact in regularity of treatment, 58% patient said other medicine affects in compliance to ART. These data will assist the health workers to detect the high risk patient who need intervention for compliance to ART.

 

 

 

INTRODUCTION :

Antiretroviral drugs (ARVs) are medications that slow or block the replication of Human Immunodeficiency Virus (HIV), help to boost the body's ability to fight of HIV infection (immune system) and decrease the viral load in the body. Antiretroviral Therapy (ART) is a term used to describe the treatment of human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS). The commonly identified factors for non adherence are forgetfulness, poor understanding of the relationship between no adherence and disease progression, side effects of drugs, alcohol and drug abuse, poor social support, poor health provider-patient relationships, being away from home, fear of disclosure, educational level, and others³.

 

MATERIAL AND METHODS:

Descriptive study to assess the factors affecting compliance of ART   among HIV patients at selected ART centers of pune city. The present study is quantitative study with non-experimental descriptive survey research design.100 samples were selected for the study by non-probability purposive sampling technique based on the selection criteria. The samples were selected from the selected from the vihan care and support center Pimpri Pune. Data was collected from structured interview schedule questionnaire to evaluate the factors affecting compliance of ART. Association of factors affecting compliance to ART with selected demographic variable was done using fisher’s exact test. & the findings will be documented in tables, graphs & diagrams. Description and inferential statistics were used for analysis.

 

RESULT:

Finding revealed that Majority of the patients with HIV In the study 53% of the patients was males. And the maximum 33% of them was from age group 31-40 years. And Maximum 38% of them had primary education. The majority of the samples 32% of them was housewives. And 84% of them had caregivers as family members. The findings of the study were 73% patients believe in ART, 72% aware about ART, 79% manage daily routine with ART,69% believe that ART increase life span.

 

92% family member know the diagnosis of patient and 74% behave well with them, m92% disclosed diagnosis in society and 31% behave good after knowing diagnosis, 75% stigma affect, 74% respond that special consideration given for ART where they doing job, 89% patient said cost of transportation affect and 52% family members support for finances. 91% said counselor cooperate with them, 62% have time to Attend OPD, 78% said counselor maintain good relation with them, and only 55% said counseling was effective for them. And 77% patient knows the side effects of ART and 71% experience the side effect, 49% patient said side effect of ART has impact in regularity of treatment, 58% patient said other medicine affects in compliance to ART. Association was done with each item by using FISHER exact test. Since p-value corresponding to gender was less than 0.05 with ‘Does the Health care provider cooperate with you’ was found to have significant association with gender of HIV patients. Since p-value corresponding to age was less than 0.05 with ‘Does your family members behave well with you’ was found to have significant association with gender of HIV patients. Since p-value corresponding to education was less than 0.05 ‘Do you believe ART will increase your life span’ and ‘Does Your family members behave well with you’ was found to have significant association with education of HIV patients. Since p-value corresponding to occupation was more than 0.05 with all this items. So it was found to have no significant association with occupation of HIV patients. Since p-value corresponding to caregivers was less than 0.05 with ‘Does Your family members behave well with you’, ‘Does the stigma affect you in compliance to the treatment’ was found to have significant association with caregivers of HIV patients. Since p-value corresponding to marital status was less than 0.05 with  ‘Do your family members know about your HIV status’ was found to have significant association with marital status of HIV patients.

 

DISCUSSION:

It should be emphasized that, The overall factors are male were more than female to non-compliant, only 72% aware about the importance of ART, only 59% manage their daily routines with ART,  maximum 89% cost of the transportation affects, 75% stigma affect, 71% experience side effects. Hence this   study reported the factors affecting to compliance of ART. And it increases the non-adherence to patient

 

CONCLUSION:

The overall experience of conducting this study was satisfying one, as there was good co-operation from patient. The study was a new learning experience for the Researcher. The aim of the study was to assess the factors affecting to compliance of antiretroviral treatment, were 73% patients believe in ART, 72% aware about ART, 69% believe that ART increase life span. 75% stigma affect, 74%respond that special consideration given for ART where they doing job,89% patient said cost of transportation affect 71% experience the side effect, 49% patient said side effect of ART has impact in regularity of treatment, 58% patient said other medicine affects in compliance to ART. These data will assist the health workers to detect the high risk patient who need intervention for compliance to ART.

 

REFRENCE:

1.     National AIDS Control Organization. Treatment, care and support [online]  Available from URL http://www.nacoonline.org/ Quick_links/publication/treatment_care_support/. 2006

2.     Dakshina Kannada, Monthly input formats of ART.India:Wenlock  Government District hospital, Mangalore; December,2012

3.     Antiretroviral therapy literacy for community- based caregivers a reference manual, http://www.safaids.net/files/LEM%202.pdf, accessed on March 09, 2012.)

4.     Y. Tadios and G. Davey, “Antiretroviral treatment adherence, Ethiopian Medical Journal, vol. 44, no. 3, pp. 237–244, 2006.

 

 

 

 

Received on 28.02.2017           Modified on 05.06.2017

Accepted on 07.07.2017         © A&V Publications all right reserved