Abstract

* 1Charles E. Okafor and Obinna I. Ekwunife

As treatment of HIV infection with antiretroviral medications becomes a reality in sub-Saharan Africa, adherence to treatment regimen becomes a challenge. A meta-analysis was conducted to summarize the reported adherence rate in sub-Saharan Africa. Forest plot was used to visualize the extent of heterogeneity among studies. Following the random effect model, the combined adherence percent was 84.31% (95% CI = 79.48% - 88.60%). The Monte Carlo sensitivity analysis provided an alternative statistical method to evaluate pooled proportion and the analysis was similar to the random effect analysis. Identified barriers to adherence include: depression, centralized ART clinic, interruption in drug supply/procurement, stigma, absence of social support, cost of ART, complacency, forgetfulness and medication related problems. Cost of ART (OR = 2.19; 95% CI= 1.65 – 2.90), Complacency (OR = 5.25; 95% CI = 2.89 – 10.80), and medication related problems (OR = 1.68; 95%CI = 1.28 – 2.22) were the strongest barriers to adherence. This study showed a good level of adherence in sub-Saharan Africa. However, barriers to adherence identified in this study could be employed to improve adherence to a near perfect level.