Factors Affecting Adherence to ART for People Living with HIV/AIDS: A Study of Sakubva Clinic

Abstract

This study investigated the factors affecting adherence to antiretroviral therapy (ART) among people living with HIV at Sakubva Clinic in Mutare. The findings revealed that adherence to ART remains suboptimal, with an overall adherence rate of 70%, which is below the recommended level required to achieve optimal viral suppression. This indicates that a substantial proportion of clients remain at risk of treatment failure, drug resistance, and poor health outcomes. The study demonstrated that socio-demographic factors play a significant role in influencing adherence to ART. Younger age groups, male gender, and lower levels of education were associated with poorer adherence. Younger clients were particularly affected by challenges such as increased mobility, stigma, and limited health literacy, which negatively impacted their ability to maintain consistent treatment. These findings highlight the need for targeted and age-specific adherence support interventions. Patient-related factors were identified as major determinants of adherence. Fear of stigma, non-disclosure of HIV status, ART-related side effects, forgetfulness, and mental health challenges such as depression and stress were prominent barriers. Participants who had disclosed their HIV status and received social support demonstrated better adherence compared to those who had not disclosed. This underscores the importance of strengthening counselling services, promoting supportive disclosure, and integrating mental health services into routine HIV care. Health system factors also significantly influenced adherence. Long waiting times at the clinic, occasional drug stock-outs, negative staff attitudes, and administrative challenges discouraged consistent clinic attendance and continuity of treatment. Although fewer participants reported negative staff attitudes, their impact on adherence was substantial. These findings emphasize the critical role of health-system strengthening in improving ART adherence. In conclusion, adherence to ART at Sakubva Clinic is influenced by a complex interaction of socio-demographic, patient-related, and health system factors. Improving adherence requires a comprehensive and holistic approach that includes enhanced adherence counselling, integration of mental health services, stigma reduction initiatives, improved clinic efficiency, and uninterrupted availability of antiretroviral drugs. Addressing these factors is essential for improving treatment outcomes, achieving viral suppression, and contributing to the attainment of national and global HIV targets such as the UNAIDS 95-95-95 goals.