Factors associated with adherence to antiretroviral therapy among adolescents and young adults attending care and treatment clinics in Tabora Municipal Council-Tabora Region

Abstract

ABSTRACT Background: Approximately 63% of adolescents living with HIV receive antiretroviral therapy (ART) in Tanzania. To maximize the clinical benefits of ART and attain a successful treatment outcome, more than 95 % adherence level is necessary. However, sustaining high levels of adherence to ART is a challenge. Underutilized adolescents –youth friendly services, such as youth adherence club, space for sports and games, privacy and confidentiality and continuous adherence counseling as well as harmful cultural practices and socio-demographic factors such as violence and older age (19-24) years, disclosure of HIV status, are some of the known barriers to achieving that high level of adherence among adolescents and young adults living with HIV/AIDS. It is not known as to whether the same barriers operate in Tabora MC. Objective: This study aimed at determining the factors associated with adherence to ART among adolescents and young adults living with HIV/AIDS in Tabora MC. Methodology: Analytical cross-sectional study was conducted among HIV-infected adolescents and young adults aged 10-24 years on ART treatment. A questionnaire was used to gather information on demographic characteristics, utilization of adolescents and friendly services, cultural practices and socio-demographic characteristics. Descriptive statistics were used to summarize demographic characteristics. Multivariate logistic regression analysis was used to analyze factors associated with suboptimal adherence to ART while controlling for potential confounders. Odds ratio and 95% confidence intervals were computed. Results: A total of 358 participants were recruited into the study, 69.8% were in the age group 19-24 years, 81.3% were single and 74.0% were students during the time of the study. Eighty clients (22.3%) reported suboptimal adherence to ART treatment. Suboptimal ART adherence was more likely among clients who had perceived stigma (AOR=1.37, 95%CI: 0.46-4.09), experience violence (AOR=2.69, 95% CI: 1.15-6.30), and older age (19-24 years) (AOR=2.61, 95% CI: 1.15-6.30). Conclusion: Adherence to ART is still below the recommended adherence level of ≥ 95%. The government and other stakeholders need to come up with effective interventions to alleviate the problem.