Factors That Influence Anti-Retroviral Therapy Adherence among Women in Lilongwe Urban Health Centres, Malawi


Introduction: Sub-SaharanAfricaremains most severely affected, with nearly1 inevery 20 adults (4.9%) living with HIV and this is accounting for 69% of the people worldwide. Although the regional prevalence of HIV infection is nearly 25 times higher in sub-Saharan Africa than in Asia, almost 5 million people are living with HIV in South, South-East and East Asia combined. Purpose: The purpose of this study was to find out the factors that influence anti-retroviral therapy adherence among women in Lilongwe Urban,Malawi. Methods: a descriptive cross-sectional design was used to study multi sites using quantitative methods. The sites were ART clinics at Area 18 health centre, and Area 25 health centre. A questionnaire was used to a convenient sample of 118 HIV positive women. Quantitative data from close-ended questions were coded and analyzed using the Statistical Package for Social Science (SPSS), version 16. Logistic regression model was used to execute the potential covariates. Findings: ART adherence among women is influenced by knowledge levels on: perceived importance and consequences for not adhering to ART; Short waiting time; good relationships with the next of kin and service providers; trust and effective coping mechanisms to stressful events. Source of information was highly associated with adherence in the logistic regression OR 2.89; CI (1.66 ± 5.38); p (0.039). Moreover, Short waiting time of the women at the hospital during the ARV refill period is highly associated with ART adherence level OR 4.11; CI (2.05 ± 6.12); p (0.021). On the other hand, factors that contribute to non-adherence are reduced knowledge level p0.002; Side effects of ART; bad relationships with service providers and relationship with the next of kin as well as occupation of the clients (women). Conclusion: Despite stressful events to HIV positive living women, this study revealed that the majority of these participants would continue taking ART if the factors are very minimal. Encouraging the women who stop taking ART particularly in urban health centres due to such factors like religious beliefs that God is superior and will heal them would influence the ART survival rate in Malawi.

Share and Cite:

N. Mbirimtengerenji, G. Jere, S. Lengu and A. Maluwa, "Factors That Influence Anti-Retroviral Therapy Adherence among Women in Lilongwe Urban Health Centres, Malawi," World Journal of AIDS, Vol. 3 No. 1, 2013, pp. 16-25. doi: 10.4236/wja.2013.31003.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] I. Anneli, “Adherence of Immune Booster among HIV Positive People in India,” Journal of Emerging Investigators, Vol. 103, No. 6, 2007, pp. 594-610.
[2] E. Araaj, “Factors Affecting Adherence of Persons Living with HIV to Antiretroviral Therapy in Lebanon,” Operational Research in Tropical and Other Communicable Diseases: Final Report Summaries, Vol. 173, No. 2007-2008, 2005, p. 32.
[3] D. Bandyopadhyay, A. K. Basu, S. K. Mandal, R. Bandyopadhyay, S. K. Pal, P. P. Chakraborty and S. Bose, “Glycaemic Consequences of HIV and Highly Active Antiretroviral Therapy: A Pilot Study and Review of Literature,” Journal of Indian Medical Association, Vol. 102, No. 8, 2004, pp. 453-456.
[4] British Columbia on Person with AIDS Society, “AntiRetroviral Therapy in Women,” Columbia, 2010.
[5] N. Burns and S. Grove, “The Practice of Nursing Research: Conduct, Critique and Utilization,” 5th Edition, Elsevier Saunders Publication Ltd., St Louis, 2005.
[6] M. Chesney, “Adherence to Highly Active Antiretroviral Therapy Regimens,” AIDS Patient Care and STDs, Vol. 17, No. 4, 2003, pp. 169-177. doi:10.1089/108729103321619773
[7] M. J. Clark, “Community Health Nursing: Advocacy for Population Health,” 5th Edition, Pearson Prentice Hall, Upper Saddle River, 2008.
[8] M. B. Cauldbeck, et al., “Adherence to Antiretroviral Therapy among HIV Patients in Bangalore,” AIDS Research and Therapy, Vol. 10, No. 6, 2009, pp. 6-7.
[9] History of HIV & AIDS in Malawi, 2007. www.avert.org
[10] A. Kagee, “Adherence to Antiretroviral Therapy in the Context of the National Roll-Out in South Africa: Defining a Research Agenda for Psychology,” South African Journal of Psychology, Vol. 38, No. 2, 2006, pp. 413-428.
[11] R. L. Klitzman, et al., “Intricacies and Inter-Relationships between HIV Disclosure and HAART: A Qualitative Study,” AIDS Care, Vol. 16, No. 5, 2004, pp. 628-640. doi:10.1080/09540120410 001716423
[12] H. Madaki, “Factors that Facilitate and Constrain Adherence to ARV Drugs among Adults at Four Public Health Facilities in Botswana: A Pre-Intervention Study Feedback to Serowe Study,” Botswana, 2009.
[13] M. Massaquoi, et al., “Patient Retention and Attrition on Anti-Retroviral Treatment at District Level in Rural Malawi,” Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol. 103, No. 6, 2009, pp. 594-600. doi:10.1016/j.trstmh.2009.02.012
[14] N. H. Miller, “Compliance with Treatment Regimens in Chronic Asymptomatic Diseases,” The American Journal of Medicine, Vol. 102, No. 2, 1997, pp. 43-49. doi:10.1016/S0002-9343(97)00467-1
[15] MOH & NAC, “Treatment of AIDS: Guidelines for the Use of ART in Malawi,” 3rd Edition, NAC, Lilongwe, 2008.
[16] H. Calverton and K. Marryland, “Malawi Demographic and Health Survey,” National Statistical Office (NSO), 2004. www.nsomalawi.mw
[17] A. W. Nyambura, “Factors that Influence Non-Adherence to Antiretroviral Therapy among HIV and AIDS Patients in Central Province,” Kenya, 2009.
[18] D. F. Polit and C. T. Beck, “Essentials of Nursing Research: Methods, Appraisal and Utilization,” 6th Edition, Williams & Wilkins Company, Philadelphia, 2006.
[19] N. R. Reynolds, et al., “Balancing Disfigurement and Fear of Disease Progression: Patient Perceptions of HIV Body Fat Redistribution,” AIDS Care, Vol. 18, No. 7, 2006, pp. 663-673. doi:10.1080/ 09540120500287051
[20] M. B. Cauldbec, C. O’Connor, M. B. O’Connor, J. A. Saunders, B. Rao, V. G. Mallesh, N. K. P. Kumar, G. Mamtha, C. McGoldrick, R. B. S. Laing and K. S. Satish, “Antiretroviral Therapy Treatment Adherence and Its Determinants in Sub-Saharan Africa: A Prospective at Yaound Cental Hospital, Cameroon,” AIDS Research and Therapy, Vol. 6, No. 7, 2009, pp. 64-67.
[21] L. N. Schonnesson, et al., “Baseline Predictors of Three Types of Antiretroviral Therapy (ART) Adherence: A Two Year Follow-Up,” AIDS Care, Vol. 18, No. 3, 2006, pp. 246-253. doi:10.1080/ 09540120500456631
[22] J. M. Suvelius, A. Carrico and M. O. Johnson, “Antiretroviral Therapy Adherence among Transgender Women Living with HIV,” Journal of the Association of Nurses in AIDS Care, Vol. 21, No. 3, 2010, pp. 246-256.
[23] N. C. Talam, “Factors Affecting Antiretroviral Drug Adherence among HIV/AIDS Adult Patients Attending HIV/AIDS Clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya,” East African Journal of Public health, Vol. 5, No. 2, 2008, pp. 74-78.
[24] Y. R. G. White, “Adherence to ARV Drug Therapy in Children with HIV/AIDS in Jamaica,” West Indian Medical Journal, Vol. 57, No. 3, 2008, pp. 56-67.
[25] WHO, “Adherence of ART Report,” African Region Report, Central Africa, 2009.
[26] UNIAIDS, “Global Summary of HIV/AIDS Epidemics,” Geneva, 2008.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.