Factors associated with non-adherence to antiretroviral therapy among HIV-infected adolescents aged 15-19 years: a snapshot from the Mother and Child Center in Yaounde, Cameroon

Abstract

Introduction non-adherence to antiretroviral therapy (ART) constitutes the main cause of therapeutic failure among HIV-infected adolescents, especially in the aged group 15 to 19 years. We aimed to determine factors associated with this non-adherence in this specific population. Methods we conducted a cross-sectional study at the Mother and Child Center in Yaounde from August to October 2018. Delayed clinic appointment was referred to as defaulters. Non-adherence was measured during the 3 days preceding inclusion by self-reported method following quantitative (missing dosage of ART), qualitative (ART taken with a delay of more than 2 hours) and combined measure. A threshold of non-adherence > 20% was considered high, with p<0.05 statistically significant. Results overall, 195 out of 251 (77.7%) eligible adolescents were included, of which 56.9% were girls (sex-ratio = 4/3). The mean age was 16.8 ± 1.5 years. The rate of defaulters was 21.0%. Following quantitative approach, 33.8% were non-adherent. Using combined approach, we had 41.0%. This non-adherence was associated with duration on ART > 5 years (adjusted Odds Ratio [aOR]: 2.33;95% Confidence Interval [CI]: 1.08-5.00; p:0.030), defaulters (aOR: 2.56;95% CI: 1.12-5.82; p:0.025) and HIV Viral Load (VL) ≥ 40 copies/ml (aOR: 0.42; 95% CI: 0.21-0.83; p:0.013). Conclusion at this reference pediatric center, 4 out of 10 adolescents aged 15-19 years on ART are non-adherent, driven by missing dosage of drug intake. Strategies for enhanced adherence for late age adolescents are therefore warranted, by prioritizing interventions on defaulters and duration on ART > 5 years.

Quality of life of people living with HIV and their adherence to antiretroviral therapy in Bukavu City, Democratic Republic of the Congo

“…This low rate of non-adherence could be explained by the therapeutic education and awareness that PLHIV received in ART clinics about the advantages of adherence and the disadvantages of non-adherence. The rate of non-adherence found in this study was lower than the one found in studies carried out in Gabon, Ethiopia and Cameroon, [29][30][31] and higher than the one reported by in Madagascar (2023). [32] The current ndings also differed from those observed in certain towns in the DRC.…”

Treatment Non-Adherence or Abandonment Among Adolescents and Young Individuals Living with HIV/AIDS: A Scoping Review

“…Table 1 allows seeing the articles (A) included according to the general characteristics: author/year, title, information source (IS), which indicates where the study was made available, locus, and language. The results of this review evidenced that the articles included were developed in Botswana (12), the United Kingdom (13), Malawi (14), Kenya (15), Ghana (16), Cameroon (17), and Cape City (7), and published in the English language between 2013 and 2021.…”

“…Some sociodemographic conditions, such as being male and single, socioeconomic factors and school status proved to be associated with difficulty adhering to the treatment among adolescents and young people with HIV/AIDS (5,12,17).…”

“…It was noticed that ART abandonment could be related to the infection itself and to the medications, such as the fact that the adolescents and young people were infected by vertical transmission, the absence of clinical consultation in the last six months, taking the medication in the same service with an adult, antiretroviral therapy time being less than five years, low self-efficacy in treatment, the treatment routine, and the presence of side effects (5,13,17).…”

“…In environments where resources are limited, approximately three-quarters of the adolescents may not adhere to ART, in addition to late diagnoses that may reflect in adherence (17). A study conducted in India shows that nearly 20 % of the patients had HIV symptoms for more than six months, which indicates the absence of HIV screening practices, consequently causing delays in diagnosis and ART initiation.…”