Gender Disparities and Determinants of Adherence to HIV/AIDS Management among Adults Attending a Tertiary Hospital in Rivers State, Nigeria
https://stm2.bookpi.org/GDHAMATRSN
<p>Human immunodeficiency virus and Acquired Immune Deficiency Syndrome, a social disease that continues to spiral over the years since the first case was diagnosed among male homosexuals in the United States of America in 1981. This global disease of public importance with significant consequences has shown the greatest vulnerability among women of reproductive age (15-49 years), prevalent in countries with its highest burden (Africa, Asia, Eastern Europe and Latin America), particularly among persons with risky sexual behaviour and associated genders disparities in the socio-cultural, socio-economic and psychosocial determinants.</p> <p>The gender differences that influence the spread of the disease, access, and adherence to treatment, care and support have been linked to low female empowerment, poor decision-making power, poverty and inequalities of wealth, as most women remain dependent on their male partners/spouses for their livelihood; thus serving as barriers to adherence to antiretroviral therapy in communities where the disease is widespread. Following a shift from the previous 2015 Joint United Nations Program on HIV/AIDS (UNAIDS) “90-90-90” treatment target to the 2020 “95-95-95” target aimed at eradicating the HIV/AIDS pandemic by the year 2030; ensuring that “95%” of all people living with HIV/AIDS will know their status; “95%” of all diagnosed HIV-positive persons will access treatment, and “95%” of those on ART will achieve virologic suppression.</p> <p>To achieve the target of ending AIDS by the year 2030, a holistic and essential approach that enables people living with HIV/AIDS to gain access to services even outside healthcare facilities is advocated. Thus, adherence to ART is the fundamental mechanism for the Sustainable Development Goal (SDG) of ending AIDS by the year 2030. However, the understanding of adherence in the context of gender disparities in the determinants that influence treatment, care, and support among People Living with HIV/AIDS is vital. This involves a client-focused, community-centred, healthcare delivery approach provided at all stages of HIV infection by a multidisciplinary team aimed at improving retention of clients already enrolled in care; as the care and support components promotes immediate access to treatment following a diagnosis of HIV, sustained adherence to Highly Active Antiretroviral Therapy (HAART) to achieve viral suppression with consequent reduction of the risk of transmission of the virus and increasing survival of infected persons.</p> <p>Beyond regularly and accurately taking antiretroviral therapy (ART), adherence to HIV/AIDS treatment, care, and support includes strictly following the prescribed regimen, including clinic visits, investigations, lifestyle changes, dietary plans, and family and social support available to all supervised infected individuals. This book is the result of extensive research that assessed how gender influences the lived experiences of people living with HIV/AIDS (PLWHA), including social support networks, stigma, healthcare access, and treatment adherence.</p> <p>This book provided gender-sensitive interventions from the perspective of HIV-positive adults accessing care at a tertiary hospital in Rivers State, Nigeria, based on their socio-cultural, economic, and psychosocial experiences, and treatment outcomes. To address the challenges facing the eradication of HIV/AIDS, it is essential that public health practitioners, clinicians, researchers, students, policymakers, and advocates effectively utilize the findings from the study as a guide to conduct future research.</p> <p>My gratitude goes to my beloved family, academic supervisors who encouraged and supported this endeavour, healthcare workers whose dedication continues to inspire hope, and all participants who generously shared their experiences with the hope that a more inclusive and empathetic approach to healthcare service delivery will pave the way for a healthier, undiscriminated future for all. This work is especially dedicated to all people living with HIV/AIDS, who, despite the experiences they encounter while accessing care, still adhere to treatment, care and support.</p>en-USGender Disparities and Determinants of Adherence to HIV/AIDS Management among Adults Attending a Tertiary Hospital in Rivers State, NigeriaGender Disparities and Determinants of Adherence to HIV/AIDS Management among Adults Attending a Tertiary Hospital in Rivers State, Nigeria
https://stm2.bookpi.org/GDHAMATRSN/article/view/543
<p>Adherence to the management of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome is beyond infected persons consistently and accurately taking fixed-dose antiretroviral therapy. This study compared the gender disparity in the self-reported adherence, virologic outcome and factors associated with HIV/AIDS management among HIV-positive adults attending a tertiary hospital in Rivers State, Nigeria.</p> <p>This concurrent nested mixed-methods approach employed a hospital-based comparative cross-sectional study for the quantitative aspect, and a grounded theory methodology for the qualitative component was conducted at the University of Port Harcourt Teaching Hospital between September and November 2020. Data from the quantitative and qualitative components were collected using a structured interviewer-administered questionnaire and focus group discussion guide to recruit participants through systematic sampling and purposive sampling techniques, then analyzed using Statistical Product and Service Solutions version 25 and ATLAS. Ti version 12, respectively.</p> <p>A total of 1600 participants (800 males and 800 females) and 24 discussants (12 males and 12 females) were recruited for the quantitative and qualitative aspects of the study, respectively. The mean and standard deviation: Age; male (44.53±10.50) and female (40.58±9.34); self-reported adherence; male (98.7±6.4), female (97.3±10.0), and the virologic suppression; male (89.5%), female (89.6%). The significant predictors of self-reported adherence: Male gender; religion (aOR=0.076, 95%=0.024-0.239, p<0.001), level of education (aOR=0.451, 95% CI=0.213-0.955, p=0.038), and not paying for HIV services (aOR=4.105, 95% CI=1.712-9.792, p<0.001. The only significant predictor of virologic outcome: Female gender; treatment supporter (aOR=0.382, 95% CI=0.206-0.707, p=0.002). The association between self-reported adherence and virologic outcome was not significant: male (89.7%, χ<sup>2</sup>=0.487, p=0.485), female (90%, χ<sup>2</sup>=1.227, p=0.268). The focus group discussion reported that socio-cultural, socioeconomic and psychosocial challenges negatively influenced treatment adherence. </p> <p>The identified factors significantly influenced the gender difference in self-reported adherence as opposed to the virologic outcome. Hence, responsible organizations should develop measures to improve virologic outcomes.</p>Luke, AnwuriOwhonda, Golden
Copyright (c) 2025 Author(s). The licensee is the publisher (BP International).
2025-10-222025-10-22115110.9734/bpi/mono/978-93-88417-46-4