Factors influencing adherence to antiretroviral therapy among HIV infected and HIV exposed children at Naivasha District Hospital

Abstract

Background: Although non-adherence to prescribed therapies is widespread, it is particularly problematic with antiretroviral therapy for human immunodeficiency virus infection. Very high levels of adherence (~95%) are required for antiretroviral therapy to be effective. There is limited information available in Kenya on adherence to antiretroviral therapy and its predictors in children. Methodology: The study design was a cross-sectional study that used structured questionnaires to interview 129 study participants. Pharmacy pill count records for each participant were abstracted from the dispensing database software. Caregivers of children in this target groups were interviewed to determine their child's adherence to their antiretroviral drugs as well as factors influencing the same. The data was then analysed using SPSS version 13.0 software. Results: The mean age of participants was 20 months while the median age was 15 months (inter-quartile range 6 - 33 months). The pharmacy pill count method yielded a mean adherence rate of 93.9%. However, only 48.1 % of the participants had optimal levels of adherence (~95%). There was a significant difference in adherence between the PMTCT regimen (94.7%) and the HAART regimen (93.4%), (P = 0.045). Treatment for co-infection was the single most significant factor influencing adherence (P < 0.005). Conclusion: Adherence to antiretroviral therapy by children on antiretroviral therapy in Naivasha district hospital was low, with more than half of them reporting sub-optimal adherence. Treatment for co-infections and regimen simplicity were found to be the major factors positively influencing adherence among this study population of paediatrics.