Adherence to Highly Active Antiretroviral Therapy and its Associated factors among HIV Infected Adolescents in Addis Ababa, Ethiopia
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Date
2014-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background: For antiretroviral therapy (ART)to work effectively, adherence is very crucial.
However, most of the studies done on ART adherence are either on children or on adults. There
is limited information on the level of adherence among adolescents. Since the physical,
biological and behavioral changes which occur during adolescence could affect ART adherence,
we endeavored to assess the level of adherence among adolescents treated at three hospitals in
Addis Ababa, Ethiopia.
Study Objective: This study was carried out to assess the magnitude of ART adherence among
HIV infected adolescents in Addis Ababa, Ethiopia. It also looked into the various sociodemographic,
behavioral
and
clinical
factors
associated
with
ART
adherence
among
adolescents.
Study Methods: Using a cross-sectional study design, 273 HIV infected adolescents receiving
ART were interviewed from three hospitals in Addis Ababa. We used a structured questionnaire
to measure adherence levels using patient self-reports among randomly selected adolescents aged
13-19 years. Data was entered using Epi Info version 3.5.4 and exported to SPSS version 21 for
analysis. Bivariate and multivariate methods were used for analysis.
Results: We interviewed 273 adolescents aged 13 to 19 years, and 144 (52.7%)of the
participants were female. Their mean age was 15.42 years (SDĀ± 1.75). The self-reported
adherence rate of the respondents was 79.1% (216/273). Most (96%)were on first line antiretroviral
drugs. The median duration on ART was 7 years (IQR, 3). On Bivariate analysis; WHO stage, being
on Cotrimoxazole Prophylactic Therapy (CPT), marital and living status of the parent, whether
parent was on ART and having special instructions for ART medications were associated with
optimum adherence. However only WHO stage IV (adjusted OR, 12.874 95% CI, 2.079-79.706),
being on CPT (adjusted OR, 0.339 CI, 0.124-0.97)and adolescents with widowed parent (Adjusted
OR, 0.087 with CI, 0.021-0.359) were significantly associated with optimum adolescent ART
adherence.
Conclusions: The level of self-reported ART adherence among HIV infected adolescents at the
three hospitals was below the recommended threshold. Being in advanced WHO clinical stage
was associated with better adherence levels, but history of taking CPT was associated with
poorer adherence. Earlier presentation of adolescents to care should be encouraged, but more
targeted adherence support should be planned for those who present at early stage of their illness.
Description
Keywords
HIV,Antiretroviral Therapy,adolescents