Exploring Factors Influencing Adherence to HIV Medication among patients using Community Pharmacies and Public Hospital: A Qualitative Study

Abstract Introduction HIV/AIDS is a major global health emergency as it is estimated that close to 40 million people live with HIV/AIDS, among which the majority are adults. Despite the availability of ARVs at community, secondary, and tertiary health facilities in Nigeria, adherence rates remain low. This study conducted in Ibadan, Nigeria, investigated factors influencing adherence to antiretroviral therapy (ART) among HIV patients. Methods The research employed a cross-sectional approach, utilizing qualitative techniques, including in-depth interviews (IDI) with patients and key informant interviews (KII) with healthcare providers and pharmacists. The target population consisted of HIV patients receiving ART at the Community Pharmacies and Public Hospital University in Ibadan. Data saturation determined sample sizes for the interviews. Results In the in-depth interviews, two primary themes emerged from the findings: “Socio-economic factors influencing adherence” and “Factors related to the process of care.” Socio-economic factors encompassed issues such as transportation costs, societal pressure, food costs, advice from third parties, and religious reasons. These factors were further categorized into economic reasons and societal pressure/misinformation, shedding light on patients’ challenges and choices. Factors related to the process of care included the cost of medication, side effects, drug-drug interactions, the quantity and duration of drug use, and discontinuation after feeling better. Key informant interviews with healthcare providers and pharmacists revealed insights into compliance by gender, financial constraints, and treatment-related factors such as side effects, drug interactions, and medication volume. Socio Cultural and religious factors, including advice from third parties, stigmatization, disclosure of status to partners, social support, and religious beliefs, played significant roles in influencing patients’ adherence. Conclusion These findings shed light on the complex interplay of factors affecting ART adherence and highlight the importance of considering economic, social, and medical aspects when designing interventions to improve adherence in HIV care. The study’s findings hold implications for healthcare programs and interventions aimed at enhancing the quality of care and support for HIV patients, particularly in resource-limited settings like Southwestern Nigeria.