Factors Affecting Antiretroviral Therapy Adherence Among Adolescents Receiving Services From Four Selected Health Facilities in Iganga District

Abstract

Introduction: The study examined the factors affecting antiretroviral therapy adherence among adolescents living with HIV in four selected health facilities in Iganga district, Uganda. Methods: A cross-sectional survey design was employed, with quantitative data collection from 222 adolescents aged 10-19 years who had been on ART for at least one year. Results: Utilizing the Morisky-Green-Levine Adherence Scale, the research assessed various adherence behaviors, revealing that 51.4% of respondents admit to occasionally forgetting their medication, while 48.6% report consistent adherence. The average adherence rate stood at 74.3%, suggesting a substantial proportion of adolescents’ exhibit adherence. Significant correlations emerged between ART adherence and health system-related factors, including distance to the HIV reference unit, health information dissemination, waiting times at the clinic, satisfaction with healthcare services, regular follow-up appointments, and support from healthcare providers. Notably, socio-economic factors exhibited a statistically significant positive correlation with adherence (Pearson Correlation = 0.271, p < 0.01), emphasizing their influential role. However, regression analysis reveals health system-related factors lack statistical significance as independent predictors of adherence (B = -0.173, p = 0.224). Conversely, socio-economic factors emerge as significant predictors of adherence (β = 0.306, p < 0.001). Furthermore, drug-related factors, such as the amount and frequency of drug intake, alongside awareness of therapy side-effects, display notable correlations with ART adherence. Conclusions: The study concluded that the current antiretroviral therapy (ART) adherence rate among adolescents in Iganga district is 74.3%, with 25.7% of adolescents not adhering to the therapy. Significant health system-related factors affecting adherence included distance to the HIV reference unit, health information dissemination, waiting times, satisfaction with healthcare services, regular follow up appointments, and supportive healthcare providers. Socio-economic and lifestyle factors, such as income, education, employment status, family support, and emotional well-being, also played a crucial role in adherence. Drug-related factors, including the amount and frequency of drugs, therapy side effects, and discomfort after taking medication, influenced adherence.