Socio-Cultural Factors Affecting Adherence to Antiretroviral Therapy among HIV Patients in Mabera Division, Kuria West Sub County, Kenya

Abstract

Human Immuno-deficiency Virus and Acquired Immune Deficiency Syndrome (HIV and AIDS) has had a devastating effect on humanity. The gains made in research have seen improvements in managing the condition and transforming HIV from an acute condition to a chronic illness that is manageable and survivable. It is estimated that 35 million people live "with HIV and AIDs globally, 25 million in Africa and 1.6 million in Kenya. Migori County has 13.4% AIDS prevalence. The health facilities records in Mabera Division of Kuria West Sub-County show that the adherence level of patients on Anti-retroviral therapy is at 98%. This does not tally with what is presented at the households by people on antiretroviral treatment, as was discussed in a community dialogue day in Mabera divisional headquarters. They suffer in silence both at the household and in the entire society in attempts to interact with others and gain courage for life support. Some of the people who live with HIV do not adhere well to therapy, are not getting better and as they routinely collect Antiretroviral drugs (ARVs) from the health facilities, their lives are not changing for the better. The overall objective was to examine the socio-cultural factors affecting adherence to antiretroviral therapy of HIV patients in Mabera division, Kuria West Sub-County, Kenya. The specific objectives were: To examine the challenges affecting the adherence to antiretroviral therapy of people living with HIV and AIDs: to determine the effect of social environment on antiretroviral therapy (ART) adherence among people living with HIV and AIDs: and to establish the cultural beliefs and practices that affect the adherence to ART among people living with HIV and AIDs in Mabera division of Kuria West Sub- County. The study was guided by the Social Cognitive theory propagated by Bandura, 1986. The theory states that behavior occurrence is attributable to interactions among behavioral, physiological and cognitive factors and the environment. The study used descriptive research design, which allowed for investigation of the situation in the community and description of phenomenon in a systematic and accurate way. The study was conducted in Mabera division, Kuria West Sub-County, Migori County, Kenya. It was carried out among a study population of 300 people living with HIV and AIDs, registered in community support groups. Stratified sampling was conducted to a sample size of 90 people, 30% of the study population. Primary data was collected through 89 questionnaires and Focus Group Discussions (FGD). The questionnaires were administered by enumerators, while the FGDs were conducted to support group leaders. FGDs consisted of one person from each support group and a total of three FGDs were conducted one in each location. The unit of analysis was individuals composed of members who were HIV positive and on ART. A pre-test of the questionnaires was conducted in a neighbouring location to assist in determining accuracy, clarity and suitability of the research instruments and to check their validity and reliability. Data collected was systematically organized, coded and entered. Both quantitative and qualitative techniques of data analysis were utilized. Qualitative data from focused group discussions was categorized into respective themes for analysis and used to enhance more understanding in the description of quantitative figures by the objectives of the study. Quantitative data was analyzed using statistical packages (SPSS) and descriptive statistics were generated to describe the data. The study found out that there are socio-cultural factors that affect ART adherence aggravated by low levels of income (87.6%), discrimination and rejection (69.7%) among others. The study has generated knowledge and identified social gaps in ART in Migori. This may call for change in policy to promote new strategies of addressing ART adherence. The study recommends capacity building for poor households, promotion of community support systems, and continuous HIV education on harmful cultural beliefs and practices in Kenya.