Level and Factors Associated with Adherence to Anti Retro Viral Drugs among Patients Attending the Anti Retro Viral Therapy (Art) Clinic of a Tertiary Center in South East Nigeria

Background:Optimal adherence to antiretroviral therapy (ART) is essential for viral suppression, prevention of drug resistance, and improved quality of life among people living with HIV (PLHIV). However, maintaining recommended adherence levels remains challenging in resourcelimited settings such as Nigeria, underscoring the need to identify adherence patterns and influencing factors to inform effective, evidence-based interventions. Method: A hospital-based cross-sectional study was conducted among PLHIV attending the antiretroviral therapy clinic of a tertiary health facility in Enugu, South-East Nigeria. Adult HIV-positive patients aged 18 years and above who had been on ART for at least one month were recruited. Data were collected using a structured questionnaire and analyzed using descriptive statistics and logistic regression to determine factors associated with non-adherence. Results: Among the 452 respondents, only 37.6% achieved optimal adherence (>95%), with a mean adherence score of 90.21 ± 13.89. About 22.8% missed at least one dose in the two weeks preceding the study, while 53.8% did not consistently follow dosage instructions. Commonly reported reasons for non-adherence included being busy with other activities, forgetting to take medications, and being away from home. Higher adherence levels were observed among participants aged 31–40 years, those with tertiary education, and urban residents. Alcohol use, smokeless tobacco use, and mobility-related factors were significant predictors of non-adherence (p < 0.05). Conclusion: Optimal adherence to ART among the participants was low. Substance use and mobility-related factors significantly influenced non-adherence, underscoring the need for targeted, context-specific adherenceenhancing interventions for PLHIV.