Since the beginning of the outbreak of Acquired Immunodeficiency Syndrome
(AIDS) epidemic, more than 78 million people have been infected with Human
Immunodeficiency Virus (HIV) and 39 million people have died globally (UNAIDS,
2014, p. 123). In Namibia, AIDS is the leading cause of death accounting for 23% of
deaths (CDC in Namibia, fact sheet, 2013, & WHO Namibia, 2011). Adherence to
medication refers to the extent to which a patient takes a medication in the way
intended by a health care provider (Machtinger & Bangsberg, 2006). Very high
levels of adherence, taking at least 95% of prescribed doses, are required to achieve
sustained suppression of HIV replication over time. Namibia has a national ART
coverage of 84%, but the coverage per health district differs (MoHSS, 2012).
A quantitative, descriptive, exploratory, cross-sectional, analytical research design
was used to assess the levels and determinants of adherence to ART in HIV infected
people in Opuwo district. Specific objectives were; to determine the levels of
adherence to ART among HIV infected people in Opuwo district and to identify
determinants of adherence to ART in Opuwo district. A structured questionnaire was
used to collect data for self-reporting method, while the pill count was conducted by
subtracting the number of pills left from those given. Pharmacy records were
reviewed to determine the appoint keeping. Health workers were also interviewed.
The study finds that the levels of adherence to ART measured by pill count and by
self-reporting were 73% and 70% respectively. The determinant which is associated
with adherence was educational level. Females had higher adherence, being
iii
employed, being married or cohabitating also favoured higher adherence. Distance to
facilities, travelling, alcohol usage, dietary requirements, side effects were identified
as barrier to adherence by not statistically significant.
The researcher recommended health education on ART, recruitments of more health
worker, tracing of defaulters and late comers, a vehicle specific for ART services,
and training at health worker at all facilities to enable them to give ART.