Is Antiretroviral Medication Adherence Related to Care Facility? Comparative Study Between HIV Clients in Community Pharmacies and Specialty Clinics in Rivers State, Nigeria

Abstract

Background: This study compared antiretroviral adherence among stable adult HIV clients receiving care at community pharmacies (CP)—licensed private facilities supervised by pharmacists—and specialty clinics (SC), which are ART clinics in tertiary hospitals. The objective was to assess differences in adherence outcomes between CP AND SC in Rivers State, Nigeria, following the decentralization of HIV care for stable ART clients.

Methods: A comparative cross-sectional study involving 165 SC clients and 166 CP clients was conducted using systematic random sampling. Stable adults (viral load <1,000 copies/mL and no complications) on ART for at least 1 year were interviewed by phone between February and April 2021. Adherence, the primary outcome, was measured using the Morisky Medication Adherence Scale-8 and classified as adherent or non-adherent. Data were analysed with SPSS 25. Ethical approval was obtained from the University of Port Harcourt Teaching Hospital and Rivers State University Teaching Hospital.

Results: Community pharmacies (CP) served slightly older, more urban, and more employed clients than specialty clinics (SC). ART adherence was higher in CP (77.7%) than SC (64.2%), a significant 13.8% difference (χ²=7.29; p=0.007). CP clients had nearly twice the odds of adherence compared to SC [OR=1.94; 95% CI: 1.19–3.15; p=0.007].

Conclusion: The study demonstrated that clients receiving ART through CP had higher adherence rates than those in SC. In view of these findings, it is recommended that the CP ART program be scaled up to other LGAs, as outcomes in CP are comparable to those observed in SC settings.