Barriers to antiretroviral therapy adherence among HIV positive adolescents accessing HIV /AIDS services; case study: Taso Mbarara

Abstract

Introduction: Several studies have showed that adolescents have suboptimal adherence globally, in sub-Saharan Africa and in Uganda. In general, adherence among adolescents to chronic medication has been found to be lower compared with younger children or adults (Ankrah, et al., 2016). Poor levels of adherence leads to ill health, drug resistance and later high mortality rates. This study aimed at identifying the levels of adherence, knowledge on adherence and barriers to adherence to ART among the adolescents on ART accessing HIV/AIDs services at TASO Mbarara, Mbarara district. Methods: A cross-sectional study employing both quantitative and qualitative data collection methods was used. It involved key informant interviews, focus group discussions and semi structured questionnaires. One hundred seventy two (172) adolescents living with HIV on antiretroviral therapy for more than six months at TASO Mbarara between ages of 10-19 years were selected by Simple random sampling. Purposive sampling technique was used to select key informants. Descriptive statistics were used to describe variables while generalized linear modeling was used to estimate the crude and adjusted prevalence ratios. Results: Data for 172 respondents was analyzed. Adherence level from this study was found to be suboptimal (44.2%).81.9% had knowledge on adherence though adherence as low. Age of 16- 19 years (APR=0.63,95%CI: 0.21 - 0 .96, P=0.0003), forgetfulness (APR=1.45, 95%CI: 1.34 - 2.48, P= 0.004), lack of disclosure (APR=1.20, 95%CI: 0.12-4.93,P=0.001) and Stigma (APR=1.62, 95%CI: 0.17-2.89, P=0.026) were significantly associated with adherence to ART. Conclusion: The level of adherence was suboptimal among adolescents. Though adolescents seemed to have knowledge on ART adherence they did not adhere well and even some did not know full package of adherence. The main barriers were age, forgetfulness, lack of disclosure and stigma. There is need for continuous education to adolescents and care takers to support adolescents adherence, encouraging adolescents to carry their drugs when going out, use of reminders, establishment of family support system, formation of peer support groups and establishment of youth friendly services to enhance disclosure and manage stigma. Recommendations empowering the caretakers, Use of reminders and memory Aids, effective family and social support system, Health education. Use of peers and establishment of youth friendly services.