Missed Doses, Treatment Interruptions and Self-Rated Adherence among Adults on Antiretroviral Therapy in Ibadan, Nigeria: A Cross-Sectional Study
Bamidele Bukunmi Kehinde *
Department of Medical Laboratory Science, Faculty of Medical Laboratory Science, Lead City University, Ibadan, Oyo State, Nigeria.
Alabi Raphael
Department of Medical Laboratory Science, Faculty of Medical Laboratory Science, Lead City University, Ibadan, Oyo State, Nigeria.
Bamidele Wemimo Taiwo
Department of Medical Laboratory Science, Faculty of Medical Laboratory Science, Lead City University, Ibadan, Oyo State, Nigeria.
Amusan Festus Olatubosun
Department of Medical Laboratory Science, Faculty of Medical Laboratory Science, Lead City University, Ibadan, Oyo State, Nigeria.
Adeniran Ramoni
Department of Medical Laboratory Science, Faculty of Medical Laboratory Science, Lead City University, Ibadan, Oyo State, Nigeria.
Adegbenle Tobiloba Jeremiah
Department of Biomedical Laboratory Science, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, P.M.B. 5017 G.P.O, Ibadan, Oyo State, Nigeria.
Ajayi Olajumoke Gbemisola
Department of Medical Laboratory Science, Faculty of Medical Laboratory Science, Lead City University, Ibadan, Oyo State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Consistent antiretroviral therapy (ART) adherence is essential for viral suppression and progress towards the UNAIDS 95-95-95 targets, but a single global self-rating may not identify specific missed doses or treatment interruptions.
Aims: To measure missed doses and treatment interruptions among adults receiving ART in Ibadan, examine their correlates, and assess whether a global self-rating reflects reported medication-taking behaviour.
Study Design: A cross-sectional study, reported in accordance with STROBE.
Place and Duration of Study: HIV clinic, Adeoyo Specialist Hospital, Ring Road, Ibadan, Oyo State, Nigeria, from March to July 2025.
Methodology: In this cross-sectional study, 100 adults receiving ART were selected using systematic sampling and completed an interviewer-administered questionnaire about missed doses during the previous seven days, dose timing, treatment interruptions lasting more than two days, and a four-level global adherence rating. Prevalences are reported with Wilson 95% confidence intervals (CIs); associations were assessed using Fisher’s exact or chi-square tests, Spearman correlation, and logistic regression.
Results: Mean age was 36.7 ± 8.0 years and 52% were male. Nineteen percent (95% CI 12.5–27.8) reported no missed doses in the previous seven days, 58% missed at least two doses, 47% (37.5–56.7) reported an interruption lasting more than two days, and 38% (29.1–47.8) always took doses on time. Only 45% (35.6–54.8) rated adherence as good or excellent. The global rating was not significantly correlated with missed doses (Spearman ρ = 0.10, P = .31) or interruptions (ρ = −0.03, P = .79); 20 of 23 participants rating adherence excellent reported at least one missed dose. No factor was significantly associated with interruption after adjustment (overall model P = .37); the unadjusted association with smoking was not statistically significant after adjustment (adjusted OR 2.03, 95% CI 0.84–4.93; P = .12).
Conclusion: Missed doses and treatment interruptions were commonly reported, and a single global self-rating did not reliably reflect reported behaviour. HIV programmes should use specific, recall-bounded questions and assess barriers to continuity of treatment. Because viral load was not measured, this study cannot determine whether reported behaviours were associated with virological failure; larger studies combining behavioural questions with viral load and other adherence measures are warranted.
Keywords: Antiretroviral therapy, medication adherence, missed doses, treatment interruption, self-reported adherence, dose timing, HIV