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

Mengesha, Melkamu Merid LU orcid ; Embibel, Mulugeta ; Gobena, Tesfaye ; Tunje, Abayneh LU ; Jerene, Degu LU and Hallström, Inger Kristensson LU (2022) In BMC Pediatrics 22(1).
Abstract

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... (More)

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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Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
and viral load, Children, HIV status disclosure, Non-adherence to ART
in
BMC Pediatrics
volume
22
issue
1
article number
653
publisher
BioMed Central (BMC)
external identifiers
  • pmid:36357856
  • scopus:85141610922
ISSN
1471-2431
DOI
10.1186/s12887-022-03697-1
project
eHealth as an aid for facilitating and supporting self-management in families with long-term childhood illness – development, evaluation and implementation in clinical practice
Improving adherence to antiretroviral therapy among adolescents living with HIV in Ethiopia
language
English
LU publication?
yes
id
759ba76e-2678-425c-b8dd-d723eba05596
date added to LUP
2022-12-05 12:07:13
date last changed
2025-03-22 01:25:03
@article{759ba76e-2678-425c-b8dd-d723eba05596,
  abstract     = {{<p>Background: In 2018, nearly 90% of the global <br>
children living with human immunodeficiency virus (HIV) were in <br>
sub-Saharan Africa (SSA). Compared to the adult population, <br>
antiretroviral therapy (ART) coverage among children was limited. <br>
However, adherence remained a problem among children though they had <br>
limited access to ART. This study was conducted to identify the risk <br>
factors of non-adherence to ART among children aged 6 to 17 years. <br>
Methods:: This case-control study was conducted in 2020 using data <br>
obtained from clinical record reviews and self-reported data from 272 <br>
caregivers of HIV-infected children aged 6–17 years. Cases and controls <br>
represented children with poor versus children with good adherence to <br>
ART, respectively. Good adherence was defined based on a past 30-day <br>
physician adherence evaluation of taking ≥ 95% of the prescribed doses. <br>
Binary logistic regression was used to identify factors associated with <br>
non-adherence to ART. All statistical tests are defined as statistically<br>
 significant at P-values &lt; 0.05. Results:: Of the 272 children, for <br>
whom data were obtained, 78 were cases and 194 were controls; females <br>
accounted for 56.3%, 32% attended secondary school, and for 83.1%, the <br>
reporting caregivers were biological parents. Non-adherent children had <br>
higher odds of association with the following risk factors: a caregiver <br>
who is a current substance user (aOR = 2.87, 95% CI: 1.44, 5.71), using <br>
AZT-and ABC-based regimen compared to the TDF-regimen (AZT-based, aOR = <br>
4.12, 95% CI: 1.43, 11.86; ABC-based, aOR = 5.58, 95% CI: 1.70, 18.30), <br>
and had an increase in viral load from baseline compared to those <br>
remained undetectable (remained at or decreased to &lt; 1000, aOR = <br>
4.87, 95% CI: 1.65, 14.33; remained at ≥ 1000, aOR = 9.30, 95% CI: 3.69,<br>
 23.46). In contrast, non-adherent children had 66% lower odds of being <br>
at early adolescent age compared to 6–9 years old (10–14 years, aOR = <br>
0.34, 95% CI: 0.12, 0.99) and had 70% lower odds of being aware of their<br>
 HIV status (aOR = 0.30, 95% CI: 0.13, 0.73). Conclusion:: Technical <br>
support to caregivers to build disclosure self-efficacy, identifying the<br>
 appropriate regimen for children, counseling on viral load suppression <br>
on subsequent visits, and helping caregivers avoid or reduce substance <br>
use may help improve the problem of children’s non-adherence to ART.</p>}},
  author       = {{Mengesha, Melkamu Merid and Embibel, Mulugeta and Gobena, Tesfaye and Tunje, Abayneh and Jerene, Degu and Hallström, Inger Kristensson}},
  issn         = {{1471-2431}},
  keywords     = {{and viral load; Children; HIV status disclosure; Non-adherence to ART}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Pediatrics}},
  title        = {{Antiretroviral therapy non-adherence among children living with HIV in Dire Dawa, Eastern Ethiopia : a case-control study}},
  url          = {{http://dx.doi.org/10.1186/s12887-022-03697-1}},
  doi          = {{10.1186/s12887-022-03697-1}},
  volume       = {{22}},
  year         = {{2022}},
}