Prevalence of Malaria Co-Infection and Antiretroviral Therapy Adherence Practices among Outpatients Living With HIV/AIDS in Ondo-State, Nigeria: A Cross-Sectional Study

Background: Malaria and HIV/AIDS burdens remain major public health concern in sub-Saharan Africa, often co-existing resulting in worsening health outcomes. This study investigates the frequencies of malaria episodes and Antiretroviral Therapy (ART) adherence practices among HIV patients registered for care and support programme at the HIV clinic unit of the University of Medical Sciences Teaching Hospital, Ondo. It explores the relationship between frequencies of presenting for malaria treatment among HIV patients and socio-demographic factors, ART regimen type and ART medication adherence. Methods: The cross-sectional study involves 246 HIV patients and a well-designed questionnaire was administered to the participants in a semi-interview manner. Their responses were corroborated with their clinic medical records to ensure accuracy. Data were analysed using SPSS, and the chi-square test was used to assess the association. Multivariate logistic regression was used to evaluate the factors predisposing patients to coming down with malaria symptoms and a p < 0.05 was considered statistically significant. Results: The overall prevalence of treated malaria episodes, at least once in the last 6 months was 43.5%. Frequencies of malaria episodes was significantly associated with age (X2= 18.79; p = 0.002), ART regimen (X2= 15.26; p = 0.002) and medication adherence (X2= 18.79; p = 0.017). The most common reasons for missed ART doses included medication burden, religious fasting and lack of privacy. These findings highlight the complex interplay between ART adherence, socio-cultural barriers, and malaria co-infection. Addressing stigma, improving treatment accessibility, and integrating malaria prevention strategies into HIV care programs are crucial for improving health outcomes. Future interventions should focus on patient-centred adherence support and optimizing ART regimens to minimize malaria risk.