Factors associated with non-adherence to antiretroviral therapy among HIVinfected Adolescents Guji Zone, South Ethiopia, 2018. A Facility Based Case Control study

Abstract

Background: Suboptimal adherence results in inadequate drug exposure and increases the likelihood of viral replication and resistance, limit future therapeutic options. High level of adherence is very crucial to maximize the usefulness of antiretroviral therapy.. This study examines factors associated with nonadherence to antiretroviral therapy among adolescents in Guji zone. Method: Institution based case control study design was employed from 26 February to 20 April, 2018. Adolescents who have suboptimal adherence were considered as cases and those who have optimal adherence were considered as control for this study. Cases and controls were recruited by consecutive sampling. Analysis was done by using SPSS version 20. Binary logistic analysis was conducted to identify candidate variables at p. value < 0.25 for multivariable logistic regression. Finally, multivariable logistic regression analysis was conducted in order to identify the factors associated with the non-adherence. P-value <=0.05 was used to observe whether there is statistical significance. Results:-A total of 297(101 cases and 196 controls) adolescents on ART were participated in this study. Being rural residents AOR 1.9(1.1-3.6), Living with unmarried/widowed and separated caregivers AOR 2.1(1.2-3.8), living with unemployed caregivers AOR 4.2(2.0-8.9), not disclosing HIV Status AOR 5(2.8-9.4), having symptom of depression for adolescents AOR 2.7(1.5-4.9), not using reminding methods AOR 2.4(1.2-4.8) and Uses of other drugs besides ART AOR 2.6(1.5-5.0) were found to be independent factors associated with non-adherence to ART among adolescents. Conclusion:-residence area, caregiver marital status, sources of income for family, disclosure status, depression status, uses of reminding methods and uses of other drugs besides ART were factors associated with non-adherence to ART among adolescents. Support from peers and family can promote adolescents adherence, as it buffers the stress associated with the illness, encourages optimism, reduces depression, and improves healthful behaviors. Provision of health education on importance of treatments and needs for adherence should be encouraged. Uses of reminding methods, continuous monitoring of clients on ART regarding uses of medications other than ART is important.