Factors Associated with Adherence to Antiretroviral Therapy Among HIV-Infected Adults In the Gambia

[[abstract]]Background: At the end of 2015, nearly 36.7 million people were living with HIV, while slightly less than half—18.2 million people—were receiving antiretroviral treatment. Although the number of people receiving treatment more than doubled between 2010 to 2015 (from 7.5 to 18.2 million), infections also increased over that period (from 15.8 million to 36.7 million) Thus the proportion of people with HIV receiving treatment remained about the same, and expanding access to treatment has not happened quickly enough to stop the spread of the disease. Reports have indicated that about two-thirds of the world's new HIV infections are in Sub-Saharan Africa. Access to ARV treatment has contributed significantly to a decrease in the world's new HIV infections through interventions administered in the prevention of mother-to-child transmission (PMTCT) programs. According to the literatures, high level of strict adherence to ARV is essential for sustained viral suppression and improvement of clients' health status and well being. Adherence to treatment is particularly important in regions where the resources required for treatment and monitoring outcomes are scarce or inadequate, such as in underdeveloped countries. The Gambia has a very fragile healthcare system that, at most levels, lacks adequate capacity and or resources to effectively monitor ARV treatment outcomes. Results of studies of adherence to ART and factors that influence it in Africa are inconsistent, not only between countries, but even within countries and within settings. However, literature on ARV treatment adherence in the Gambia is insufficient for designing effective intervention programs.. Purpose of the study: To understand the factors associated with adherence to antiretroviral treatment among HIV-infected adults in The Gambia.Methodology: A descriptive cross sectional study design was adopted to collect data using a structured questionnaire with face-to-face interviews of the respondents to identify the factors associated with adherence to antiretroviral therapy among HIV-infected adults in the Gambia. An adopted, modified, and pre-tested questionnaire was administered to 160 consented respondents receiving ARV treatment at the Hands on Care Clinic in Brikama town, the Gambia. Adherence was assessed by a self-report of the respondents with a recall period of within 7 days prior to the visit at the clinic for medication refills. Those who not missed or delay a dose for ≥90 minutes were considered adherent. Results: Out of this total study respondents, 80% (n=128) were females while the remaining 20% (n=32) were males. Their ages ranged from 18 to 68 years with a mean age of 42.95 (SD10.272). More than two-third of the respondents, 68.8% (n=110) were married at the time of the interview, while the remaining less than one-third of the respondents 31.2% (n=50) were single. About 88.8% (n=142) of the respondents reported to have adhered to their treatment. The majority 82.5% (n=132) of the respondents had a total knowledge score of ≥70.0% implying having good knowledge about ART. The most common reasons for missing ART doses reported by the respondents were, "Travelled without medication" 38.9% (n=7), "Medications finished while on travel" 22.2% (n=4), and " Fell asleep /slept through dose time" (n=3). Knowledge about ART and HIV treatment regimen show an association with adherence with corresponding p-values of 0.011 and