Default from Anti-Retroviral Treatment Programme in Sagamu, Nigeria

To determine the rate and reason for default from antiretroviral treatment (ART) program in Sagamu Nigeria, a cohort of 100 patients on ART was followed up for 12 months at the centre for special studies Olabisi Onabanjo University Teaching Hospital Sagamu between July 2000 and September 2003. The patient chart at the clinic were reviewed to collect the socio-demographic data of patients who defaulted ART treatment (defined as PLWA who refused to come back to collect ART medications for at least 6 months from the last visit). The patients were traced to their place of residence with the address given on the clinic chart. Where such patients were found at home, a reason for default from treatment was inquired from them. For those who were not met at home proxy interviewees such as a neighbour or a family member were asked if they were available. Of the 100 patients who had enrolled in the ART treatment programme during the study period, 36% of the study population defaulted treatment, 18% had died while 46% were alive and well. Major reasons for default includes: opting for spiritual/faith/alternative healing ( 8%), lost of interest in the programme/financial (7%), moved to home town of origin (6%), changed address (5%), untraceable home address or name (5%), side effects of ART (2%), widowhood rites (1%). Two individuals were not met at home after repeated visits by the Community health extension workers. About a third of PLWA defaulted from treatment. The major reasons for default were psychosocial factors unrelated to the treatment regimen. Ensuring adherence to therapy in communities must take into consideration the psychosocial and cultural practices and norms of the people to avert the emergence and transmission of drug-resistant strains