Page 135 - GHES-3-1

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

or interruptions in treatment, which compromises its being less compliant with ART. This finding differs with
effectiveness. the results from Mbuagbaw et al. (2012) in Cameroon,
Conversely, the perception that the opening hours of where multiple reminder methods were associated with
HIV-related services were limited significantly increased better adherence. The discrepancy may arise because over-
the chance of poor adherence to ART. This perception can reliance on these tools can reduce the ability to remember
undermine trust between patients and medical staff, making to take medication without reminders, leading to neglect
patients less inclined to share their concerns, difficulties, or when reminders are unavailable. In addition, over time,
questions about treatment. In addition, inaccessible HIV- psychological resistance or indifference to reminders
related services can lead to practical barriers to treatment may develop, causing them to be ignored or deactivated.
adherence. Incompatible schedules, long travel distances, However, using reminder tools can create a false sense
or high costs can discourage patients from regularly of security, leading to complacency about taking the
visiting medical facilities or pharmacies to obtain their medication. Thus, we should recognize that reminder
medication, leading to treatment interruptions or delays in tools can be useful, but they should be used with other
taking medication, compromising its effectiveness. adherence strategies and tailored to individual needs to
promote optimal adherence to ART.
Discomfort when taking medication significantly
increases the risk of poor adherence to ART, a finding Notably, only 60.64% of individuals agreed to
consistent with results from Isika et al. (2022) in Nigeria participate in the study, which could introduce a significant
and Arrieta-Martínez et al. (2022) in Colombia. This self-selection bias. This relatively low participation rate
discomfort may be due to undesirable side effects caused indicates that those who chose to participate may have
distinct characteristics from those who declined. In
by some antiretroviral drugs, such as nausea, headaches, particular, these participants may be more motivated to
fatigue, or gastrointestinal disorders. These side effects can follow ART rigorously or more committed to their medical
be unpleasant and uncomfortable, discouraging patients follow-up. Consequently, the frequency of poor adherence
from taking their medication regularly as prescribed. to ART could be underestimated. Individuals who agreed
Moreover, ART often requires daily dosing at specific times, to participate could be those with better adherence to
which can be restrictive for some people. The constraints treatment or who are more aware of ART-related issues,
of taking medication regularly can be difficult to reconcile which may not necessarily reflect the behaviors of the
with the demands of daily life, particularly for those with general PLHIV population. This self-selection bias may
jobs or family responsibilities, can be challenging. Patients thus limit the generalizability of the study results and mask
may feel constrained by the strict rhythm of treatment, the true extent of the ART non-adherence problem in the
leading to feelings of embarrassment and frustration.
wider population.
However, recent treatment initiation significantly
increased the possibility of poor adherence to ART, 4.1. Study limitations
a finding consistent with results from Mbopi-Kéou Our study’s limitations lie mainly in its methodology and
et al. (2012) in Cameroon, Do et al. (2010) in Botswana, the population studied. First, using a non-probabilistic
and Lantche et al. (2021) in Cameroon, which indicate convenience method for participant selection could
that adherence to ART improves with longer treatment introduce a selection bias, limiting the generalizability
duration. This result may be due to the undesirable side of the results. In addition, data collection from a single
effects accompanying the initiation of a new treatment, hospital may restrict the representativeness of the
such as nausea, headaches, or fatigue, which may reduce findings. Furthermore, the cross-sectional nature of
the patient’s motivation to continue treatment rigorously. the study does not allow the establishment of causal
These side effects can also lead to anxiety and concern relationships between the factors studied and ART
about the long-term tolerability of treatment. In addition, adherence. Moreover, this study is based on self-reported
starting a new treatment can lead to upheavals in the data, which may be subject to recall bias and social
patient’s daily routine, making it difficult to adapt to the new desirability bias.
medication demands. Constraints such as busy schedules,
frequent travel, or family obligations can interfere with 5. Conclusions
the regular intake of the patient’s medication. In addition, This study highlights several factors associated with non-
psychosocial factors such as stress, depression, or lack of adherence to ART among PLHIV. The results underline
support can negatively influence compliance. the importance of considering various aspects such as
Furthermore, this study revealed that using reminder the management of medical appointments, consumption
tools for therapy significantly increased the likelihood of habits, concerns about confidentiality of HIV status, and

Volume 3 Issue 1 (2025) 127 https://doi.org/10.36922/ghes.4077