Association of ART non-adherence with self-reported behavior and lifestyle among injecting drug users in the coastal region of Kenya

There is a public health concern with the possible widespread of Antiretroviral Therapy (ART) drug-resistance. The widespread resistance could be due to risky behavior and lifestyle of Injecting Drug Users (IDUs) resulting into non-adherence to ART. However, few studies have investigated association...

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Main Authors: Gabriel O. Ng'ong'a, Raphael M. Lwembe, Veronicah Knight, Daniel Randa, Romuald J Ściborski, George Ayodo
Format: Article
Language:English
Published: Elsevier 2023-07-01
Series:Scientific African
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S246822762300056X
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author Gabriel O. Ng'ong'a
Raphael M. Lwembe
Veronicah Knight
Daniel Randa
Romuald J Ściborski
George Ayodo
author_facet Gabriel O. Ng'ong'a
Raphael M. Lwembe
Veronicah Knight
Daniel Randa
Romuald J Ściborski
George Ayodo
author_sort Gabriel O. Ng'ong'a
collection DOAJ
description There is a public health concern with the possible widespread of Antiretroviral Therapy (ART) drug-resistance. The widespread resistance could be due to risky behavior and lifestyle of Injecting Drug Users (IDUs) resulting into non-adherence to ART. However, few studies have investigated association of ART non-adherence with the risky behavior and lifestyle of IDUs. A cross-sectional study design was adopted to investigate ART non-adherence association with the risky behavior and lifestyle among 200 IDUs from Malindi in the coastal region of Kenya. Structured questionnaire was used to collect data while exponential discriminative snowball sampling was used for the recruitment of the study participants. Self-reported non-adherence was defined as taking less than 90% of daily ART doses, variable such as missed or stopped ART was used. Chi-square (χ2) tests were used to establish the relationship between various risk behaviors and ART adherence, while binary logistic regression model was used to test the association between independent variables (risky behavior and lifestyle) and dependent variable (ART non-adherence). A significant number 32% of the study participants reported non-adherence to ART, with 17% practicing risky sexual behaviors, 14% being commercial sex workers (CSW) while 89% had multiple sexual partners. Non-adherence to ART was associated with duration of drug use (OR = 6.73; 95%Cl = 1.93-23.0; P = 0.003), IDU/CSW (OR = 6.04; 95%Cl = 3.65-10.0; P = 0.001), needle sharing (OR = 2.96; 95%Cl = 1.60-5.46; P = 0.001) and commercial sex work (OR = 2.16; 95%Cl = 1.40-4.81; P = 0.001). This study reveals that multiple sex, commercial sex, same gender sex, imprisonment, needle share in prison, being in rehabilitation and duration on ART are associated with ART non-adherence among IDUs. Consequently, health education should focus on behavior and lifestyle change to avert potential widespread drug resistance within and beyond the population of IDUs.
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spelling doaj.art-bda4d3315a3a4f6da276c791bffe5c002023-06-17T05:19:39ZengElsevierScientific African2468-22762023-07-0120e01598Association of ART non-adherence with self-reported behavior and lifestyle among injecting drug users in the coastal region of KenyaGabriel O. Ng'ong'a0Raphael M. Lwembe1Veronicah Knight2Daniel Randa3Romuald J Ściborski4George Ayodo5Jaramogi Oginga Odinga University of Science and Technology (JOOUST), Bondo P.O. Box 210 - 40601, Kenya; Siaya Institute of Technology (SIT), Siaya P.O. Box I087-40600, Kenya; Corresponding author at: Jaramogi Oginga Odinga University of Science and Technology (JOOUST), Bondo P.O. Box 210–40601, Kenya.Kenya Medical Research Institute (KEMRI), Nairobi P.O. Box 54840-00200, KenyaJaramogi Oginga Odinga University of Science and Technology (JOOUST), Bondo P.O. Box 210 - 40601, Kenya; Kenya Medical Research Institute (KEMRI), Nairobi P.O. Box 54840-00200, KenyaSiaya Institute of Technology (SIT), Siaya P.O. Box I087-40600, KenyaJaramogi Oginga Odinga University of Science and Technology (JOOUST), Bondo P.O. Box 210 - 40601, Kenya; The European-African Cluster for Public Health and Biotechnology, KenyaJaramogi Oginga Odinga University of Science and Technology (JOOUST), Bondo P.O. Box 210 - 40601, Kenya; Kenya Medical Research Institute (KEMRI), Nairobi P.O. Box 54840-00200, KenyaThere is a public health concern with the possible widespread of Antiretroviral Therapy (ART) drug-resistance. The widespread resistance could be due to risky behavior and lifestyle of Injecting Drug Users (IDUs) resulting into non-adherence to ART. However, few studies have investigated association of ART non-adherence with the risky behavior and lifestyle of IDUs. A cross-sectional study design was adopted to investigate ART non-adherence association with the risky behavior and lifestyle among 200 IDUs from Malindi in the coastal region of Kenya. Structured questionnaire was used to collect data while exponential discriminative snowball sampling was used for the recruitment of the study participants. Self-reported non-adherence was defined as taking less than 90% of daily ART doses, variable such as missed or stopped ART was used. Chi-square (χ2) tests were used to establish the relationship between various risk behaviors and ART adherence, while binary logistic regression model was used to test the association between independent variables (risky behavior and lifestyle) and dependent variable (ART non-adherence). A significant number 32% of the study participants reported non-adherence to ART, with 17% practicing risky sexual behaviors, 14% being commercial sex workers (CSW) while 89% had multiple sexual partners. Non-adherence to ART was associated with duration of drug use (OR = 6.73; 95%Cl = 1.93-23.0; P = 0.003), IDU/CSW (OR = 6.04; 95%Cl = 3.65-10.0; P = 0.001), needle sharing (OR = 2.96; 95%Cl = 1.60-5.46; P = 0.001) and commercial sex work (OR = 2.16; 95%Cl = 1.40-4.81; P = 0.001). This study reveals that multiple sex, commercial sex, same gender sex, imprisonment, needle share in prison, being in rehabilitation and duration on ART are associated with ART non-adherence among IDUs. Consequently, health education should focus on behavior and lifestyle change to avert potential widespread drug resistance within and beyond the population of IDUs.http://www.sciencedirect.com/science/article/pii/S246822762300056XIDUsARTNon-adherence
spellingShingle Gabriel O. Ng'ong'a
Raphael M. Lwembe
Veronicah Knight
Daniel Randa
Romuald J Ściborski
George Ayodo
Association of ART non-adherence with self-reported behavior and lifestyle among injecting drug users in the coastal region of Kenya
Scientific African
IDUs
ART
Non-adherence
title Association of ART non-adherence with self-reported behavior and lifestyle among injecting drug users in the coastal region of Kenya
title_full Association of ART non-adherence with self-reported behavior and lifestyle among injecting drug users in the coastal region of Kenya
title_fullStr Association of ART non-adherence with self-reported behavior and lifestyle among injecting drug users in the coastal region of Kenya
title_full_unstemmed Association of ART non-adherence with self-reported behavior and lifestyle among injecting drug users in the coastal region of Kenya
title_short Association of ART non-adherence with self-reported behavior and lifestyle among injecting drug users in the coastal region of Kenya
title_sort association of art non adherence with self reported behavior and lifestyle among injecting drug users in the coastal region of kenya
topic IDUs
ART
Non-adherence
url http://www.sciencedirect.com/science/article/pii/S246822762300056X
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