Level of Adherence and Factors Associated with Antiretroviral Therapy among HIV Infected Children in Selected Public Hospitals, Addis Ababa, Ethiopia

Abstract

Background: Non-adherence to Antiretroviral Therapy (ART) has serious consequences both on the individual and the society. It diminishes the effectiveness of viral suppression, promotes viral resistance, and places the individual at risk of hospitalization, opportunistic infection, and HIV transmission.
Objective: To assess the level of adherence and factors associated with Antiretroviral Therapy among HIV infected children in selected public hospitals, Addis Ababa, Ethiopia.
Methods: A hospital based cross-sectional study was conducted on 380 under-fifteen years old children who had been taking ART for at least 6 months, and on their respective caregivers. It was conducted at pediatrics ART units of the selected hospitals from January to March, 2014. From five public hospitals that were giving the service, two were selected through simple random sampling technique. The data were entered into Epi Info 3.5.3 and analyzed using SPSS Version 20. The statistical association between the outcome and predictor variables were assessed by logistic regression model, using adjusted Odds Ratio with its 95% CI. P-value < 0.05 was considered statistically significant
Results: As 380 of the caregivers of the children were interviewed, a response rate of 95% was obtained. The level of adherence to ART was 355 (93.4%). The main reason for 7(28%) of the non-adherent participants skipping their treatment was forgetting. The factors that had statistical association with the adherence were the caregivers’ with secondary and above educational status (AOR=4.17, 95%CI: 1.30, 13.32); the Child’s age <5years (AOR=11.24, 95%CI: 1.32, 95.45); lack of nutritional support (AOR=0.40, 95%CI: 0.005, 0.308); and the children who were aware of their HIV sero-status (AOR=4.26, 95%CI: 1.48, 12.18).
Conclusion: The level of adherence to ART in the study area was suboptimal. The caregivers’ educational status, the age of the children, lack of nutritional support, and non-disclosure sero-status were associated with non-adherence to ART. Since forgetting was the main reason reported for missing ART doses, use of reminders should be encouraged. The caregivers should inform the children about their sero-status. Additionally, the caregivers and the clinicians should look for various means to meet the nutritional requirements of the children. In general, a collaborative effort of all stakeholders is recommended to enhance adherence to ART among HIV infected children.