Do peer support groups have an effect on medication adherence? A study among people living with HIV/AIDS in Enugu State, Nigeria

Background: The health benefits of antiretroviral treatment greatly depend on the extent to which people living with HIV/AIDS adhere to the prescribed daily dosing regimens. Peer support groups are expected to have a high impact on adherence to medication among people living with HIV/AIDS. Objectives: This study was designed to determine factors affecting adherence to medication among people living with HIV/AIDS in peer support and non-support groups attending antiretroviral clinics in Enugu State, Nigeria. Method: This was a cross-sectional, comparative study using qualitative and quantitative instruments among 840 people living with HIV/AIDS attending antiretroviral clinics in Enugu, Nigeria. Quantitative data was analysed using IBM SPSS version 22. A Chi-square test of statistical significance, a student t-test and multivariate analysis using binary logistic regression were used in the analysis. Manual content analysis was done for the qualitative data. Results: The mean age of respondents was comparable in both study groups: support group 38.5 +/- 9.6; and non-support group 38.5 +/- 10.1. A significantly higher proportion of respondents in the support group (91.9%) achieved good adherence compared with those in the non-support group (87.1%). A good medication adherence self-rating was a predictor of adherence in both study groups: support group (AOR 5.8, 95% CI: 2.7-12.2, p=<0.001) and non-support group (AOR 0.2, 95% CI: 0.1-0.4, p=<0.001). Conclusion: The peer-based intervention is a viable and effective tool for maintaining optimal adherence among people living with HIV/AIDS in resource-limited settings; hence, research should concentrate on interventions that do not focus on individuals alone, but rather on those that strengthen the capacity of groups to collectively participate in HIV programmes.