Adolescent's and youth's adherence to antiretroviral therapy for better treatment outcome and its determinants: multi-center study in public health facilities

Yihenew Zurbachew; Desta Hiko; Girma Bacha; Hailu Merga

doi:10.1186/s12981-023-00588-y

Adolescent's and youth's adherence to antiretroviral therapy for better treatment outcome and its determinants: multi-center study in public health facilities

AIDS Res Ther. 2023 Dec 19;20(1):91. doi: 10.1186/s12981-023-00588-y.

Authors

Yihenew Zurbachew¹, Desta Hiko², Girma Bacha³, Hailu Merga⁴

Affiliations

¹ AIDS Healthcare Foundation, Addis Ababa, Ethiopia.
² Department of Epidemiology, Institute of Health, Jimma University, Jimma, Ethiopia.
³ Department of Nursing, Institute of Health, Jimma University, Jimma, Ethiopia.
⁴ Department of Epidemiology, Institute of Health, Jimma University, Jimma, Ethiopia. hailu.merga2014@gmail.com.

Abstract

Background: Low-adherence to Anti-retroviral therapy (ART) negatively affects the clinical, immunological, and virologic outcomes of patients. Adherence is the most important factor in determining Antiretroviral Therapy (ART) treatment success and long-term viral suppression which ultimately reduces morbidity and mortality. Thus, this study aimed to identify factors affecting adherence to antiretroviral therapy among adolescents and youth living with HIV.

Methods: Facility-based cross-sectional study was conducted from March 21 to April 30, 2020 among 316 respondents in selected five high-loaded hospitals with adolescent and youth clients using systematic random sampling technique. Patients' adherence was assessed when they had reportedly taken 95% or higher of their prescribed antiretroviral drugs in the five days before the interview. Data were collected, entered into EPI Data and exported to SPSS for analysis. Binary logistic regression was used to see the association between dependent and independent variables.

Results: In this study, 316 respondents participated in the study, with a 99.7% response rate. The mean age of respondents were 17.94 years and majority of them (58.5%) were females. The overall ART adherence among adolescents and youths was found to be 70.6%. Being female (AOR = 0.323, 95% CI, 0.164-0.637), presence of opportunistic infection (AOR = 0.483, 95% CI, 0.249-0.936), taking additional medication beside ART (AOR = 0.436, 95% CI, 0.206-0.922) and availability of youth friendly services within the facility (AOR = 2.206, 95% CI, 1.031-4.721) were found to be predictors.

Conclusion: The adherence rate in this study was low which is below the recommended adherence level. Being female, taking additional medication beside ART and presence of opportunistic infection were determinants of adherence. As a result, significant work must be done on opportunistic infection prevention through health education and promotion for screening and risk reduction. Similarly, adolescents and youths service integration with the ART Clinic is strongly advised.

Keywords: Addis Ababa; Adherence; Adolescent; Antiretroviral therapy (ART); Determinants; Ethiopia; Youth.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Cross-Sectional Studies
Ethiopia
Female
HIV Infections* / diagnosis
HIV Infections* / drug therapy
HIV Infections* / epidemiology
Hospitals
Humans
Male
Medication Adherence
Opportunistic Infections*
Treatment Outcome