Factors affecting adherence to antiretroviral therapy among children and adolescents living with HIV in the Mbita Sub-County Hospital, Homa Bay- Kenya|
Tanyi, William N; Gachuno, Onesmus; Odero, Theresa; Farquhar, Carey; Kimosop, David & Mayi, Allan
Background: Adequate adherence to antiretroviral therapy (ART) is key to the successful treatment of children and adolescents
living with HIV. Continuous ART Adherence is the key factor for virologic suppression and stability of the immune
system and prevents the occurrence of opportunistic infections. Children and adolescents struggle with adherence to ART
for various reasons, including a poor psychosocial support system and clinic attendance.
Objectives: To describe the uptake of HIV treatment services among children and adolescents in the Mbita Sub-County
Hospital, Homa Bay and determine how schooling, clinic attendance, and type of pill/regimen affect adherence to ART and
Methods: This retrospective study was conducted at the Mbita Sub-County Hospital. Medical chart data was abstracted
from the hospital files of children and adolescents between the ages of 0-19 years on antiretroviral therapy, between the
periods of October 2016 and September, 2017. Data was analyzed using measures of central tendency, and cross-tabulations
were done to compare schooling, clinic attendance, type of pill/regimen and viral suppression. Univariate and multivariate
logistic regression analyses were conducted to determine associations between groups.
Results: According to patient files reviewed, majority of patients, 244(91.4%) were enrolled into care within 2 weeks of
HIV diagnosis according to guidelines, and 193(73.1 %) remained enrolled in care at end of study period. An overall viral
suppression of 74.2 %( 132) was recorded. Of all the files reviewed, 121(74.7%) of patients attending school suppressed
against 11(68.8 %) out of school, p=0.280. Suppression among Day and boarding reported at 78.6 %( 11) and 74.8 %( 113)
of those out of school, respectively, p=0.533. Participants in primary school, 17(85.0%) suppressed better than those in
secondary school, 102(73.4%), p=0.263. Keeping clinic appointments among eligible patient files reviewed decreased from
83.1% at 3 months, p=0.016, to 76.6%, p=0.526 at 6 months and to 52.9% at 12 months, p=0.278. Only 3- month clinic
appointment return rates and Enhanced Adherence Counseling (EAC) were significant predictors of viral supression χ2 (2)
= 0.280, p = 0.869 (> 0.05).
Conclusion: The clinic attendance rate within the first 3 months, and Enhanced Adherence Counseling (EAC) were significant
predictors of viral suppression, and therefore adherence to antiretroviral therapy.
Adherence; clinic attendance; antiretroviral therapy; HIV; virologic suppression.