Page 132 - GHES-3-1

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

Table 4. Health system factors associated with poor adherence to ART
Explanatory variables Adherence to ART OR (95% CI) P‑value
Good (n=150) Poor (n=159)
Present medication after recovering in the hospital
Fixed dose 144 (96) 150 (94)
Variable dose 6 (4) 9 (6) 1.44 (0.50 – 4.39) 0.499
Time taken to reach the hospital by foot (h)
<1 126 (84) 143 (90) 1
1 – 2 21 (14) 15 (9) 0.62 (0.30 – 1.25) 0.191
>2 3 (2) 1 (1) 1.07 (0.06 – 2.4) 0.985
Difficulty obtaining medication
No 123 (82) 147 (92) 1
Yes 27 (18) 12 (8) 0.37 (0.17 – 0.74) 0.207
Victim of stigmatization by healthcare providers
No 120 (80) 126 (79) 1
Yes 30 (20) 33 (21) 1.04 (0.60 – 1.82) 0.869
Insufficient confidentiality of HIV-related services
No 81 (54) 27 (17) 1
Yes 69 (46) 132 (83) 5.73 (3.43 – 9.82) <0.001***
Limited opening hours for HIV-related services
No 69 (46) 12 (8) 1
Yes 81 (54) 147 (92) 10.43 (5.51 – 21.29) <0.001***
Notes: *p<0.05; **p<0.01; ***p<0.001.
Abbreviations: OR: Odds ratio; CI: Confidence interval; HIV: Human immunodeficiency virus; ART: Antiretroviral therapy.

of HIV-related services (AOR = 9.27 [95% CI: 1.05 – 15.09]; medication, recent initiation of treatment, and use of
p = 0.0002), discomfort when taking medication (AOR = 2.17 reminder tools for therapy were all independent predictors
[95% CI: 0.19 – 8.1]; p = 0.002), recent treatment initiation of poor adherence to ART.
(AOR = 2.68 [95% CI: 1.54 – 4.48]; p = 0.0047), and the use Failure to attend scheduled appointments at the
of therapy reminders (AOR = 2.01 [95% CI: 1.67 – 9.24]; HIV ward was significantly associated with poor ART
p = 0.019) significantly increased the odds of being less adherence, consistent with the result obtained by Kim et al.
compliant with ART. (2018) in Asia, where not visiting a hospital increased the
4. Discussion risk of poor ART adherence. This result may be attributed
to the inability of medical staff to ensure correct treatment
At the end of our investigation, we found that the overall adherence if patients miss appointments, which also
prevalence of self-reported poor adherence to ART was prevents the identification of any difficulties the patients
51.5%, which was lower than that reported by Collinet might be experiencing. Therefore, this discontinuity in
(2019) in Gabon (66%) and Addo et al. (2022) in Ghana follow-up can undermine the relationship of trust between
(55.1%) but higher than that reported by Isika et al. (2022) the patient and the health-care team, which is essential in
in Nigeria (39.9%) and Do et al. (2010) in Botswana promoting good compliance. Moreover, failure to attend
(18.3%). This discrepancy can be attributed to differences scheduled appointments may be a sign of personal, social,
in study settings, geographical locations, and age groups or psychological difficulties, which may compromise
of participants. In addition, variations in sample size and compliance. Thus, identifying these signals is crucial for
study period may result in different estimates. providing appropriate support and assisting patients in
Furthermore, multivariate analysis indicated that failure overcoming obstacles to consistent treatment.
to attend scheduled appointments, use of stimulants/ The consumption of stimulants/cigarettes significantly
cigarettes, fear of HIV status disclosure, limited opening increases the risk of poor ART adherence. This finding
hours of HIV-related services, discomfort when taking aligns with the results reported by Isika et al. (2022)

Volume 3 Issue 1 (2025) 124 https://doi.org/10.36922/ghes.4077