Page 128 - GHES-3-1

Global Health Economics and
Sustainability
Adherence to ART among HIV patients in Cameroon

health system-related factors, and therapy-related factors. 3. Results
We pretested the questionnaire with 25 participants, and
feedback on comprehension of the questions, clarity, and Data were collected between January and April 2024, during
length of the interview was recorded. which 511 patients were recruited. Of these 511 patients,
309 consented to participate in the study, representing a
2.5. Definition and operationalization of variables 60.46% participation rate.
Adherence to ART was assessed by asking whether 3.1. Description of participant characteristics
“participants had missed ART 2 times in the month
before the study.” Those who had missed treatment on two Table 1 shows the distribution of participants based on
occasions had poor adherence, and those who had not age, sex, marital status, occupation, area of residence,
missed treatment had good adherence. educational level, number of people in the household,
household income, and cohabitation. The most represented
2.6. Data collection procedure age group was 45 – 60 years (50%), with an average age
After obtaining the necessary research authorization, of 41.12 ± 12.97 years. Women slightly outnumbered
we requested a meeting with the head of the HIV care men (64.1% vs. 35.9%). Most respondents were married
department, who permitted us to contact the patients. (59.2%), worked in the private sector (32%), lived in an
Upon contacting the patients, the investigator introduced urban area (91.3%), had a higher educational level (64.1%),
himself, explained the reasons for his presence as well as lived in a household of four to five people (53.4%), had a
the study’s objectives and activities using an information monthly income between 100,000 and 300,000 (37.9%),
leaflet, and answered any questions the patients had and lived with their family (94.2%).
to ensure clear understanding. The patients signed the 3.2. Frequency of poor adherence to ART among
informed consent after agreeing to participate in the PLHIV at Cité des Palmiers District Hospital
study. Subsequently, a questionnaire was administered
face-to-face, and those who refused were considered non- Figure 1 shows that 48.5% of participants were adherent to
respondents. The data were obtained anonymously to ART and 51.5% were not.
guarantee confidentiality, with each participant identified
by a unique code assigned for this study. 3.3. Sociodemographic factors associated with poor
adherence to ART among PLHIV at Cité des Palmiers
The inclusion criteria were PLHIV aged 15 – 60 years District Hospital
who were followed up at the Cité des Palmiers District
Hospital in Douala and either signed informed consent or Table 2 shows that male participants (OR = 2.82 [95%
received parental approval. The exclusion criteria included CI: 1.74 – 4.63]; p < 0.001), those who were married
PLHIV aged ≤15 years, those aged ≥60 years, those who (OR = 3.12 [95% CI: 1.91 – 5.18]; p < 0.001) or widowed
had relocated during the collection period, and those aged (OR = 3.65 [95% CI: 1.17 – 12.62]; p = 0.029), and those
15 – 60 years who did not provide consent. working in the private (OR = 2.01 [95% CI: 1.06 – 3.91];
p = 0.034) or public sector (OR = 6.42 [95% CI: 2.65 – 16.78];
2.7. Data processing and analysis p < 0.001) were more likely to be less compliant with
Data collected using the Kobo Collect application ART. In addition, participants with a higher educational
were compiled and analyzed using Rstudio software level (OR = 5.74 [95% CI: 2.34 – 16.22]; p = 0.0003) and
version 4.2.4. Microsoft Office Excel 2013 was used to a monthly income of <100,000 FCFA (OR = 2.43 [95%
create the tables. Descriptive statistics were calculated CI: 1.30 – 4.61]; p = 0.005) or between 100,000 and 300,000
for all variables considered. The analysis of this study FCFA (OR = 2.60 [95% CI: 1.55 – 4.38]; p = 0.0002) also
considered one dependent variable (adherence to ART) presented an increased risk of poor adherence to ART.
and several independent variables divided into four groups 3.4. Patient factors associated with poor adherence
(sociodemographic characteristics, patient-related factors, to ART among PLHIV at Cité des Palmiers District
health system-related factors, and therapy-related factors). Hospital
The association between the dependent and independent
variables was determined using binary logistic regression, Table 3 shows that participants who had missed an
and all variables with p < 0.05 in bivariate analysis were appointment at the HIV management unit (OR = 4.13 [95%
candidates for multivariate analysis. The various indicators CI: 2.58 – 6.68]; p < 0.001), occasionally consumed excitants
were estimated with a significance level of alpha (α) = 0.05, or cigarettes (OR = 9.33 [95% CI: 5.28 – 17.23]; p < 0.001),
and associations were considered significant for p < 0.05 traveled frequently (OR = 6.38 [95% CI: 3.61 – 11.7];
using a two-tailed test. p < 0.001), were very busy (OR = 5.22 [95% CI: 2.94 – 9.63];

Volume 3 Issue 1 (2025) 120 https://doi.org/10.36922/ghes.4077