Determinants of Non-Adherence to Antiretroviral Therapy among HIV Positive Adolescents in a Tertiary Hospital in North Central Nigeria
Tar Bem
Department of Family Medicine, Federal Medical Centre, Makurdi, Benue, Nigeria.
Nwagbo Ambrose Nnaemeka *
Department of Veterinary Pathology, College of Veterinary Medicine, Joseph Sarwuan Tarka University Makurdi, Benue State, Nigeria.
Odo Micheal Chukwuemeka
Department of Community Medicine, Federal Medical Centre Makurdi, Benue State, Nigeria.
Ocheifa Matthew Ngbede
Department of Family Medicine, Federal Medical Centre, Makurdi, Benue, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aim: The aim of this present study was to determine the prevalence of non-adherence to ART and identify the determinants of non-adherence among HIV-positive adolescents attending a tertiary hospital in north central Nigeria. Non-adherence to antiretroviral therapy (ART) is a major problem in the care of HIV positive adolescents on antiretroviral treatment because it is thought to impact negatively on their treatment. The prevalence of non-adherence to antiretroviral therapy among adolescent in sub-Saharan Africa is between 40 and 50%. Nigeria has a prevalence of 58%.
Study Design: Using a facility-based cross-sectional study,
Place and Duration of the Study: At sexually transmitted infections clinic, Federal Medical Centre Makurdi, Benue State, Nigeria from January 2023 to October 2024.
Methodology: A total of 417 consenting HIV-positive adolescents aged 10-19 years, who had been on ART for at least six months, were recruited using convenience sampling. Data collection included socio-demographic characteristics, the eight-item Morisky medication adherence scale (8-mmas), and an eight-item self-developed scale to assess barriers to adherence. Data analysis was conducted using the statistical package for social sciences (SPSS) software (version 23.0). Socio-demographic characteristics, prevalence of non-adherence, and determinants of non-adherence were reported as percentages. Chi-square, fisher test, and logistic regression were employed to identify determinants of non-adherence, with a significance level set at p < 0.05.
Results: The prevalence of non-adherence to ART among the study participants was 77.7%. Non-adherence was significantly associated with age, education level, occupation, ethnicity, and fear of stigmatization.
Conclusion: Enhanced adherence counseling, targeted interventions for at-risk adolescents, and a comprehensive approach that includes adherence assessment for those fearing stigmatizations and with unsuppressed viral loads are recommended. These strategies may improve long-term therapeutic success and facilitate the transition from pediatric to adult care in this population.
Keywords: Non-adherence, antiretroviral therapy (ART), HIV-positive adolescents, determinants, stigmatization