Factors associated with adherence to Anti-Retroviral Therapy (ART) among HIV positive adolescents and young persons in Mbale Regional Referral Hospital.

Abstract

ABSTRACT Introduction: HIV epidemic is one of the biggest public health issues the world has ever seen in recent history. In the last three decades, HIV has spread rapidly and affected all sectors of society: young people and adults, men and women, and the rich and the poor. The Uganda population HIV impact assessment survey indicated that the HIV prevalence was 6% among all age groups with 1.3 million people living with HIV nationally[2]. The study also indicated that prevalence among age groups 15-19 years was 1.1% and 3.3% among age group 20-24 years indicating that HIV infections remains an issue in these age groups. General objectives. The overall objective of the study was to assess the factors associated with adherence to ART among HIV infected adolescents and young persons aged 10-24 years enrolled at Mbale Regional Referral hospital in Eastern Uganda. Methods: The cross-sectional study employed only quantitative methods of data collection. Data was collected from 331 eligible HIV infected adolescents and young persons aged 10-24 years attending ART clinic at Mbale Regional Referral Hospital. We used pill count method to measure adherence to ART and defined good adherence as ≥95%, and poor adherence as less than 95%. Pre-tested structured questionnaire was used to collect quantitative data on factors associated with ART adherence. Univariate analysis was used to describe the study respondents using frequencies and proportions. Bivariate and multivariate data was analyzed using Poisson regression model. Results: Overall, of the 331 HIV positive adolescents and young persons who participated in the study, 78.3% (n=259) had good adherence (≥95%) and 21.7% (n=72) had poor adherence (<95%) in the last three month by pill count method. In the adjusted prevalence ratio, only experiencing no side effects of ART medication (P-value= 0.003, APR=1.4 [1.126-1.757]) and having no missed XII clinic appointments (P-value=0.038), APR=1.3[1.015-1.672]) were statistically significant with good ART adherence. Being ever married, having secondary and tertiary level of education, being employed and Anglican were associated with good adherence to ART but this association was not statistically significant. Having no other medications and experiencing no side effects of ART medication were significantly associated with good adherence to ART. Meanwhile, adolescents who found it easy to discuss with their providers (APR=2.1[0.628-6.838]), felt providers were helpful (APR= 2.7[0.370-20.159]) and had no missed clinic appointments were associated with good adherence to ART (P-value=0.038), APR=1.3[1.015-1.672]). Conclusions: Having secondary and tertiary level of education, being married, having an occupation and not taking alcohol were associated with good adherence to ART. Taking no other medications to ARVs and experiencing no side effects of ART medication were associated with good adherence to ART. Having friendly, helpful and non-judgmental health providers and keeping clinic appointments were associated with good ART adherence.