Determinants of antiretroviral treatment adherence among patients attending secondary health care facilities in north-east and south-west Nigeria: a comparative study

Background: Four decades after its discovery, HIV continues to be a major global public health issue, even with antiretroviral therapy (ART). Strict adherence to ART remains a challenge, with attendant implications for treatment success. This study aimed at comparing ART adherence between north-east and south-west Nigeria. Methods: A comparative cross-sectional study was conducted in two regions in Nigeria among 400 HIV/AIDS patients on ART. Data were collected using a pre-tested, semi-structured interviewer-administered questionnaire. Multivariable analysis was performed to determine predictors of ART adherence in the regions. The level of significance was set at 0.05. Results: The majority of respondents from both the north-east (87.5%) and south-west (92.5%) of Nigeria had good knowledge about ART. The self-reported adherence level was 90.0% in the north-east and 87.5% in the south-west. Predictors of ART adherence in the north-east were knowledge about ART (AOR 9.949; 95% CI 2.009-49.284) and transport costs to the clinic (AOR 0.177; 95% CI 0.047-0.661). In the south-west, education (AOR 0.198; 95% CI 0.047-0.832) and knowledge of ART (AOR 8.945; 95% CI 1.749-45.751) were identified as predictors of ART adherence. Conclusion: In both regions, knowledge about ART was appreciable, but adherence was sub-optimal. Strategies to support adherence should be tailored to specific predictors in each region.