Journal of
AIDS and HIV Research

  • Abbreviation: J. AIDS HIV Res.
  • Language: English
  • ISSN: 2141-2359
  • DOI: 10.5897/JAHR
  • Start Year: 2009
  • Published Articles: 283

Full Length Research Paper

Determinants of antiretroviral therapy adherence among older adolescents living with HIV in Kenya during the transition to adult care: An observational study

Nyawira Gitahi
  • Nyawira Gitahi
  • Institute of Tropical Medicine and Infectious Disease, Kenya Medical Research Institute, Nairobi, Kenya.
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Samuel Wahome
  • Samuel Wahome
  • Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
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Maricianah Onono
  • Maricianah Onono
  • Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
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Elizabeth A. Bukusi
  • Elizabeth A. Bukusi
  • Institute of Tropical Medicine and Infectious Disease, Kenya Medical Research Institute, Nairobi, Kenya.
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Kenneth Ngure
  • Kenneth Ngure
  • Department. of Community Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
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  •  Received: 22 June 2020
  •  Accepted: 08 September 2020
  •  Published: 31 October 2020

Abstract

Lower levels of adherence to antiretroviral therapy (ART) among older adolescents as compared to adults are influenced by individual, psychosocial, and treatment-related factors. Successful transition of older adolescents into HIV adult care from paediatric & adolescent focused care requires an understanding of barriers to ART adherence. This study aimed at determining individual factors affecting ART adherence among older HIV positive adolescents transitioning to adult care. Between December 2018 and January 2019, we conducted a cross-sectional study among 82 perinatally infected adolescents aged 16-19 years in an HIV care and treatment clinic in Nairobi, Kenya. We used completed structured questionnaires and abstracted data from clinical charts. We performed multivariate logistic regression to identify factors independently associated >95% self-reported ART adherence (7-day recall). The study participants had a median age of 17 (IQR 16,18) on ART for a median duration of 11 years (IQR 7,13). Sixty-four per cent (52) of the adolescents reported optimal adherence was of >95%, and 15% reported missing doses for three or more months. Self -reported adherence had a high correlation with viral loads of <1000 copies ml (Kappa= 0.087). Adolescents with high self-efficacy were eight times more likely to report adherence of >95% [OR 8.1, 95% CI (2.31- 28.18)]. Once a day, dosing was also independently associated with adherence [OR 1.58, 95 %CI [0.62-4.08].

Conclusions: The reduction of ART pill burden and the inclusion of assessment of ART self –efficacy may contribute to transition preparedness among adolescents..

Key words: Transition, adolescents, HIV, adherence, antiretroviral therapy, self-efficacy.