Levels of Adherence and Associated Factors Among Children on ART Over Time in Northwest, Ethiopia: Evidence from a Multicenter Follow-Up Study

GebreEyesus, Fisha Alebel; Mitku, Dagninet; Tarekegn, Tadesse Tsehay; Temere, Bogale; Terefe, Tamene Fetene; Belete, Amsalu; Legas, Getasew; Feleke, Dejen Getaneh; Taye, Moges Gelaw; Baye, Nega Dagnew; Admasu, Fitalew Tadele; Dagnew, Enyew; Liyeh, Tewachew Muche; Jimma, Melkamu Senbeta; Chanie, Ermias Sisay

doi:10.2147/hiv.s323090

Cited by 6 publications

(13 citation statements)

References 38 publications

(39 reference statements)

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“…Research evidence indicates that experiencing side effects associated with a given medication leads to poor adherence [36]. Consistent with previous studies [15,37,38], we found that, compared to the Tenofevir-based regimen, non-adherent children had a higher odds of receiving Zidovudine-and Abacabir-based regimens.…”

Section: Discussionsupporting

confidence: 90%

Antiretroviral therapy non-adherence among children living with HIV in Dire Dawa, Eastern Ethiopia: a case-control study

et al. 2022

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Background: In 2018, nearly 90% of the global children living with human immunodeficiency virus (HIV) were in sub-Saharan Africa (SSA). Compared to the adult population, antiretroviral therapy (ART) coverage among children was limited. However, adherence remained a problem among children though they had limited access to ART. This study was conducted to identify the risk factors of non-adherence to ART among children aged 6 to 17 years. Methods: This case-control study was conducted in 2020 using data obtained from clinical record reviews and self-reported data from 272 caregivers of HIV-infected children aged 6–17 years. Cases and controls represented children with poor versus children with good adherence to ART, respectively. Good adherence was defined based on a past 30-day physician adherence evaluation of taking ≥ 95% of the prescribed doses. Binary logistic regression was used to identify factors associated with non-adherence to ART. All statistical tests are defined as statistically significant at P-values < 0.05. Results: Of the 272 children, for whom data were obtained, 78 were cases and 194 were controls; females accounted for 56.3%, 32% attended secondary school, and for 83.1%, the reporting caregivers were biological parents. Non-adherent children had higher odds of association with the following risk factors: a caregiver who is a current substance user (aOR = 2.87, 95% CI: 1.44, 5.71), using AZT-and ABC-based regimen compared to the TDF-regimen (AZT-based, aOR = 4.12, 95% CI: 1.43, 11.86; ABC-based, aOR = 5.58, 95% CI: 1.70, 18.30), and had an increase in viral load from baseline compared to those remained undetectable (remained at or decreased to < 1000, aOR = 4.87, 95% CI: 1.65, 14.33; remained at ≥ 1000, aOR = 9.30, 95% CI: 3.69, 23.46). In contrast, non-adherent children had 66% lower odds of being at early adolescent age compared to 6–9 years old (10–14 years, aOR = 0.34, 95% CI: 0.12, 0.99) and had 70% lower odds of being aware of their HIV status (aOR = 0.30, 95% CI: 0.13, 0.73). Conclusion: Technical support to caregivers to build disclosure self-efficacy, identifying the appropriate regimen for children, counseling on viral load suppression on subsequent visits, and helping caregivers avoid or reduce substance use may help improve the problem of children’s non-adherence to ART.

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Section: Discussionsupporting

confidence: 90%

Antiretroviral therapy non-adherence among children living with HIV in Dire Dawa, Eastern Ethiopia: a case-control study

et al. 2022

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“…As far as our knowledge is concerned, there is a shortage of regional wide research done recently on factors affecting the development of TB among HIV-infected adults under HAART in the study area. 12 Therefore, this research has been conducted with the objective to investigate factors affecting the development of TB among HIV patients under treatment followed in 17 government hospitals in the region. The current investigation also aimed to triangulate whether previously identified factors in developed countries also worked in the study area (low-income country).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for the Development of Tuberculosis Among HIV-Positive Adults Under Highly Active Antiretroviral Therapy at Government Hospitals in Amhara Region, Ethiopia

Tegegne¹,

Minwagaw

2022

IJGM

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Background Tuberculosis is one of the leading infectious diseases for people living with HIV. Therefore, the purpose of this study was to investigate factors affecting the development of TB among HIV-positive adults under treatment in government hospitals of Amhara Region, Ethiopia. Methods A hospital-based retrospective study design was conducted among 700 HIV-positive adults under HAART in 17 government hospitals in the Amhara region, Ethiopia. Results Age of the patients (AOR = 1.122, 95% CI:1.013, 2.234), baseline CD4 cell count (AOR = 0.888, 95% CI: 0.714, 0.945), patients living without their partner (AOR = 1.212, 95% CI: 1.051, 1.123), females under treatment (AOR = 0.786, 95% CI; 0.564, 0.845), non-opportunistic diseases (AOR = 0.865, 95% CI: 0.731, 0.938), patients not disclosed their HIV status (AOR = 1.241, 95% CI: 1.087, 2.341), rural patients (AOR = 1.135, 95% CI: 1.032, 1.453, patient with no education (AOR = 1.125, 95% CI: 1.056, 1.546), low adherence patients (AOR = 1.225, 95% CI: 1.191, 2.453), bedridden patients (AOR = 1.223, 95% CI: 1.131, 1.521), ambulatory patients (AOR = 1.156, 95% CI:1.091, 1.267), non-smoker patients (AOR = 0.854, 95% CI: 0.686, 0.935) significantly affected on the variable of interest. Similarly, alcohol intake, drug toxicity and baseline clinical WHO stages significantly affected for the development of tuberculosis in HIV-positive patients under treatment. Conclusion In this study, baseline CD4 cell count, female patients, non-opportunistic diseases, and non-smoking status were negatively associated with the development of TB, whereas age of patients, living without partners, patients with no education, patients with low adherence, bedridden and ambulatory patients were positively associated to the development of TB in HIV patients. The findings obtained in this study are important for both service providers and patients. More attention should be given to those positively associated variables to response variables. The regional health bureau should open TB/HIV co-infection subsections like ART sections in each hospital.

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“…When compared to other studies, ART adherence among Swati adolescents was higher than in studies conducted among ALHIV in South Africa (65%), Kenya (76%) and Zimbabwe (28%) while comparable with studies conducted in Nigeria (85%), Uganda (80%), Cameroon (83%) [10,16,22,38–40]. These discrepancies among the countries could be due to the differences in outcome measurements, settings, sample sizes, and study designs as explained in a study conducted in Ethiopia among children on ART [21].…”

Section: Discussionmentioning

confidence: 72%

“…Several factors associated with ART adherence have been identified among studies. These include age, sex, missing clinical appointment, presence of opportunistic diseases, duration on ART, ART regimen, family support, type of health facility, World Health Organization (WHO) clinical staging, VLS, and CD4-count [10,18,[20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Determinants of anti-retroviral therapy adherence among adolescents living with HIV in the Kingdom of Eswatini

Hlophe,

Shumba,

Bedada

et al. 2023

Preprint

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BackgroundThe success of antiretroviral therapy (ART) depends on a high level of adherence to the life-long therapy of 95% and above. However, in Eswatini, adolescents and young people aged 15 to 24 years, have poor ART adherence as evidenced by low viral load (VL) suppression rates (76% and 63% among female and males respectively) compared to the general population (96%). The wide age-band of 15 to 24 years in reporting viral suppression rates means that adolescent specific data is limited, and younger adolescents aged 10-14 years are excluded. This study explored the level of ART adherence and associated factors among adolescents living with HIV (ALHIV) aged 10 to 19 years on ART in Eswatini.MethodsWe performed a retrospective analysis of 911 medical records of ALHIV aged 10 to 19 years on ART for at least a month in Eswatini for the period 1stJanuary 2017 to 30thSeptember 2022. Bivariate logistic regression was fitted for each predictor variable. Missing values were imputed using multiple imputation by chained equation (MICE). Statistically significant (p-value ≤0.2) predictor variables were included in a multivariable logistic regression model. P-value ≤0.05 was used to declare statistical significance in the final regression model.ResultsART adherence of 88.5% was recorded with higher adherence among males (88.9%) than females (87.8%). Hhohho region had highest adherence (90.7%) while Shiselweni region had lowest adherence (82%). Adherence was low among ALHIV with a non-suppressed baseline VL result (65.3%) and those assigned to multi-month ART model of care at ART initiation (66.7%). The Shiselweni region (OR 0.47; 95%CI 0.26-2.78), suppressed baseline VL result (OR 5.49; 95%CI 3.36-8,96) and assigned to the main-stream ART care model (OR 0.22; 95%CI 0.05-0.95) were statistically associated with ART adherence. In the multivariable regression analysis, only Shiselweni region and suppressed baseline VL result were statistically associated with ART adherence.ConclusionEswatini ALHIV have a low ART adherence compared to general population. Shiselweni region is negatively associated with ART adherence among ALHIV while a suppressed baseline VL is positively associated with improved ART adherence. There is therefore a need to intensify interventions aimed at early ART initiation and intensive follow-up and support among ALHIV especially in the Shiselweni region.

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Levels of Adherence and Associated Factors Among Children on ART Over Time in Northwest, Ethiopia: Evidence from a Multicenter Follow-Up Study

Cited by 6 publications

References 38 publications

Antiretroviral therapy non-adherence among children living with HIV in Dire Dawa, Eastern Ethiopia: a case-control study

Antiretroviral therapy non-adherence among children living with HIV in Dire Dawa, Eastern Ethiopia: a case-control study

Risk Factors for the Development of Tuberculosis Among HIV-Positive Adults Under Highly Active Antiretroviral Therapy at Government Hospitals in Amhara Region, Ethiopia

Determinants of anti-retroviral therapy adherence among adolescents living with HIV in the Kingdom of Eswatini

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