Research Article
Barriers to Antiretroviral Treatment Adherence Among Refugees Living with HIV/AIDS in Douala, Cameroon
Ebong Serge Bruno*
,
Yemene Rodrigue,
Tefe Tagne Robert,
Ekwi Damian Nsongmayi,
Lendem Isabelle,
Mballa Amougou Jean Claude,
Nke Martine,
Edima Hélène Carole,
Mbebi Enone Juste Patient,
Bika Claude,
Adiogo Dieudonné,
Eboumbou Else Carole
Issue:
Volume 10, Issue 2, December 2024
Pages:
45-56
Received:
11 November 2024
Accepted:
22 November 2024
Published:
9 December 2024
Abstract: The success of antiretroviral treatment (ART) depends on adherence. Adherence is necessary to reduce the risk of resistance, restore immunity, and reduce incidence, morbidity and mortality. Data on the ratio of refugees and conflict-affected people living with HIV and on ART needs are scarce. The objective of this study is to identify barriers to ART adherence among refugees living with HIV/AIDS in Douala. In a cross-sectional, analytical study conducted among refugees living with HIV/AIDS in Douala and followed in health facilities that are partners of the High Commissioner for Refugees (HCR). Adherence was evaluated on the basis of patient declarations (declared adherence) and the regularity of the renewal of their prescriptions (calculated adherence). The quantitative data collected with the anonymous questionnaire administered after informed consent was entered with Epi Info version 7.1.3.0. Descriptive and inferential analysis was carried out with SPSS version 17.0, which allowed us to determine the association between predisposing factors and adherence to antiretroviral treatment using Pearson's Chi-square test. 200 refugees meeting our inclusion criteria were interviewed. The average length of follow-up was 4 years. The average age was 40.66 ± 9.35 years and the sex ratio was 2.39 in favour of the female sex. 91.5% of the refugees had started treatment more than a year ago. The level of reported compliance was significantly lower than the overall level of calculated compliance (67.5% vs. 71.0%, P=0.000). The main obstacles to adherence were forgetting and lack of food. People who received accurate information about their illness were more observant (P=0.000). Adherence to antiretroviral treatment was best when the year of initiation of treatment was two years or more (P=0.000) and the patient knew the duration of treatment (p=0.000). The low adherence rate (<95%) among refugees was related to several factors. The difference observed between the results of the two methods used to estimate adherence shows us the need for biological methods in assessing the level of treatment adherence. Measures will be needed to improve the level of adherence among refugees, including the strengthening of psycho-social support.
Abstract: The success of antiretroviral treatment (ART) depends on adherence. Adherence is necessary to reduce the risk of resistance, restore immunity, and reduce incidence, morbidity and mortality. Data on the ratio of refugees and conflict-affected people living with HIV and on ART needs are scarce. The objective of this study is to identify barriers to A...
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