| dc.description.abstract | Objective
Whereas free ARVs are accessible to majority of HIV infected patients; adherence to ART is still a major challenge in public health especially among adolescents. Poor adherence can lead to increased viral load, reduced CD4 counts, resistance to drugs; which eventually lead to increased morbidity and mortality among adolescents. The study aimed at evaluating the factors influencing adherence to anti-retroviral therapy among HIV and AIDS infected adolescents.
Methodology
The cross- who were on ART at Nsambya Home Care and the Aids Support Organisation (TASO). adolescents between 10-19 years completed a self-administered questionnaire with open and close-ended questions. Key informant interviews for healthcare providers and caregivers were conducted to assess individual factors, health care facility related factors; drug-related factors; and school /home related factors affecting adherence among in or out of school adolescents. Data was presented using graphs and frequency tables. Data was analysed using SPSS (version 11.5).
Results
Out of 173 participants, 136 completed the questionnaire. Forty-seven percent of adolescents who were in school; and forty six percent of adolescents who were out of school adhered (≥95% adherence). Among these were 59 (56.7%) adolescents from Nsambya and 25 (43.3%) from Taso. About 35 (35%) adolescents who were in school and 6 (25%) adolescents out of school adhered using the one week self report measure. The one day self-report revealed that 84 (80.8%) adolescents in school and 13 (54.2%) out of school adolescents adhered to ART. Only 48 (48.5%) adolescents in school and 11 (47.8%) adolescents out of school adhered to ART on a 5 day self report. On the other hand, the pill count measure showed that all adolescents attained ≤95% adherence (sub-optimal) with majority taking between 80-94% of their medication during the period under review.
The factors which were significantly associated with adherence to ART among adolescents in schools were; distance one lives away from the health centre (χ2 = 4 .266, df = 1, p= 0.039< 0.05), religion (X2 = 22, df, = 12, p = 0.034), alcohol consumption (X2 = 6, df = 2, P =.048); and the maximum time one can wait at the health centre (X2 = 9.52, df = 4, P =.049).
The following factors influenced adherence among school going adolescents though they did not have statistical significance.
Peer support clubs; privacy; non-disclosure; lack of water for swallowing drugs; school schedules and pill burden.
Adherence among adadolescents who were out of school was greatly influenced by the transport to clinic; poor diet; stigma and lifestyle
Both groups were equally affected by reaction to drugs; forgetfulness; duration on ART and type of drug; and poor counselling services by healthcare service providers. Key informants revealed that transport to clinics for pill re-fills; denial of permission, attitude of healthcare service providers and stigma affected adherence to ART negatively among both groups. | en_US |
