A new study conducted by the Nigerian Institute of Medical Research (NIMR) has found that equipping HIV patients with vocational skills significantly improves their adherence to antiretroviral therapy (ART), highlighting the economic dimensions of healthcare outcomes in low-resource settings.
Presenting the findings at the institute’s monthly chat held at the NIMR facility in Yaba, a biostatistician and Senior Research Fellow at NIMR, Dr. Kazeem Osuolale, explained that while ART has transformed HIV into a manageable chronic illness, adherence remains a challenge for many patients, primarily due to economic hardship. He said the study sought to address this by testing whether skill-based empowerment could support consistent treatment among people living with HIV.
According to him, poverty remains a major obstacle in Nigeria’s fight against HIV/AIDS, as many patients struggle to cover costs associated with accessing care, such as transportation, clinic registration, and other related expenses. “Even though the drugs are free, the financial burden of accessing them regularly makes adherence difficult for many patients,” he stated.
To explore a possible solution, the research team designed a pilot randomised controlled trial titled “Empowerment Models for Improving Human Immunodeficiency Virus (HIV) Patients’ Adherence to Antiretroviral Drugs.” The trial was conducted between July 2021 and February 2023 and involved 50 HIV-positive patients aged 15 to 45, all of whom had been on ART for at least three months but had adherence rates below 95 per cent.
Participants were divided into two groups: an experimental group that received empowerment through vocational skills training and start-up materials, and a control group that received no such intervention. The training covered areas such as catering, bead making, liquid soap production, and hair braiding. According to Osuolale, the intervention aimed not only to offer economic support but also to boost the participants’ confidence and independence.
The researcher reported that the experimental group showed a dramatic increase in ART adherence from a baseline average of 68.76 per cent to 109.72 per cent after the intervention. In contrast, the control group, which started at an average of 83.66 per cent, recorded a smaller post-intervention increase to 99.44 per cent. Statistical analysis confirmed the significance of this improvement, with a p-value of 0.044.
“The empowerment intervention effectively reduced financial stress and removed common barriers to accessing treatment. When patients are financially empowered, they are more likely to keep clinic appointments and pick up their medication regularly,” he said.
Further analysis revealed notable differences in income levels between the two groups. In the experimental group, 16 out of 25 participants earned between N0 and N15,000 monthly, compared to just 8 in the control group, underscoring the financial vulnerability of patients and the potential impact of economic support.
While no major differences were observed between the two groups in terms of age, marital status, education, or employment type, the economic intervention stood out as the primary factor influencing improved adherence.
Osuolale acknowledged that the study’s small sample size and three-month follow-up period limited the generalizability of its findings. He recommended that future research explore the long-term effects of economic empowerment on ART adherence using larger sample sizes.
He concluded by urging policymakers and HIV care program funders to integrate empowerment strategies into routine care. “It is time we invest not only in medication but in the lives of patients. Skills give them purpose, independence, and the financial capacity to stay on treatment,” he said.
