Children’s Adherence to Antiretroviral Therapy and Associated Factors: Multi-center Cross-sectional Study

Abstract

Background- Suboptimal adherence to antiretroviral therapy will lead to drug resistance, treatment failure, clinical deterioration, death and failure to thrive in children. Studies conducted among children below 15 years old were limited in Ethiopia in general and in the study area in particular. Therefore, this study aimed to assess the status of children’s adherence to ART and associated factors in the study area. Methods- We conducted a facility-based cross-sectional study by including 282 children <15 year who received anti-retroviral therapy for at least one month. All children/caregivers who were attending the ART clinic during the data collection period were consecutively recruited for the study. Both bivariate and multivariate logistic regression were performed. Result- Out of 282 caregivers included with their children, 226 (80.2%) were females (mean age= 38.6 and SD = 12.35), and out of the total children, half (50%) were female and 246 (87.2%) were between the ages 5–14 years (mean age= 8.5 and SD = 2.64). Two hundred forty six (87.2%) children had an adherence status of ≥95% in the month prior to the interview. Children whose caregivers were residing in urban areas were 3.3 (95% CI: 1.17, 9.63) times more adherent to ART than those whose caregivers were residing in rural areas. Children whose caregivers were biological parents were 2.37(95% CI: 1.59, 3.3) times more adherent than those whose caregivers were non-biological parents. Additionally, children of caregivers who were knowledgeable about ART treatment, were 4.5(95% CI: 1.79, 9.8) times more adherent to ART than their counterparts.Conclusion and recommendation- The adherence status of children in our study area was comparable. Being biological caregivers, residing in urban areas and knowledgeable about ART treatment facilitate adherence to ART. Ongoing education about treatment and further study with multiple adherence assessment methods were recommended.