| dc.description.abstract | Antiretroviral therapy adherence is the whole process of a given treatment regimen to control HIV viral replication and improve immune system. Non-adherence is the discontinuation or cessation of part or all of the treatment. Discordant couples are a pair of long-term sexual partners where one partner is HIV-infected and the other is not. Globally, non-adherence to antiretroviral treatment services has resulted in a dramatic increase in HIV-related mortality and morbidity. In 2017, Kenya had HIV prevalence stood at 4.9%, an estimated 1.5 million Kenyans were living with HIV, of whom 1,136,000 were on ART. Siaya County reported 38% new HIV cases, 60% of which were couples in sexual relationships. Usigu ward had (17.5%) which is highest rate, of non-adherence among discordant couples. The main objective of this study was to assess the determinants of adherence to antiretroviral therapy among discordant couples in Usigu ward, Bondo Sub County. The study adopted a descriptive study design, targeting 1300 discordant couples enrolled on care within the seven health facilities in Usigu Ward, with a sample size of 389 respondents. The respondents for quantitative research were randomly selected from the (7) health facility within Usigu ward. Seven (7) healthcare providers working at comprehensive care Centers were purposively sampled and interviewed for qualitative research data later were triangulated. Data was collected using structured and semi-structured questionnaires and key informant interviews guides. Quantitative data was analyzed using Stata version 14, while qualitative data was analyzed using thematic analysis (Nvivo 11). Pearson correlation and logical regression model was used for inferential statistics. The results of this study revealed that regular follow-up and good provider-patient relationship improves retention on ART. Giving information on related ART side effects at 76.2% increased ART adherence and 88.6% of the respondents were taken through ART adherence sessions. About 56.9% of the respondents agreed that having joined discordant support groups are helpful, lastly 60.9% of respondents had experienced stigma and fear of disclosure and some of the determinants influencing ART adherence include, constant migration of fisher fork, forgetfulness and ART side effects. The results revealed that these independent variables caused a variation of 3% or (r
=0.19) on Adherence to ART among discordant couples and 26% adhered to ART. The results also show that ART Awareness, Adherence Sessions and Discordant Couple Group Membership were statistically significant at p-value of 0.004.This study concluded that, use of appointment cards, motivation of health workers, support from CHVs and peer educators increased retention and active follow up of discordant couples on ART. Giving key information on ART use, knowledge and belief on importance of were positively associated with ART adherence. Disclosure of HIV status, reduced stigma and enabling most discordant couples joint support groups. The study also recommended, The County government of Siaya and implementing partners to actively follow up, retain discordant couples on ART, offer continuous adherence sessions to give key information, knowledge and beliefs on ART Care. Joining discordant couple support groups helps reduce stigma and enabled disclosure on ART to improve ART adherence among discordant couples. | en_US |