Predictors of Non-Adherence to Antiretroviral Therapy among Adolescents Living with HIV in the Centre Region of Cameroon

Alice Ketchaji^{1, 2,} , Felix Assah³, Joseph Fokam⁴, Elvis Asangbeng Tanue⁵, Francisca Monebenimp³ and Marcelin Ngowe Ngowe⁶

¹Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon

²Department for the Control of Disease, Epidemics and Pandemics, Ministry of Public Health, Yaoundé, Cameroon

³Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon;

⁴Department of Microbiology, Haematology, Immunology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon;

⁵Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon;

⁶Department of Surgery, Faculty of Health Sciences, University of Buea, Buea, Cameroon

Cite this paper

Alice Ketchaji, Felix Assah, Joseph Fokam, Elvis Asangbeng Tanue, Francisca Monebenimp and Marcelin Ngowe Ngowe. Predictors of Non-Adherence to Antiretroviral Therapy among Adolescents Living with HIV in the Centre Region of Cameroon. American Journal of Public Health Research. 2019; 7(4):126-136. doi: 10.12691/AJPHR-7-4-1

Abstract

Introduction: In spite of progress in antiretroviral therapy (ART) programs, adolescents remain largely vulnerable to poor ART outcomes, due to non-adherence. In the frame of limited evidence on ART adherence during adolescence in resource-constrained settings, we aimed at evaluating the rate of adherence to ART among adolescents and associated factors in Cameroon. Methods: A cross-sectional study was conducted among 401 adolescents receiving ART in 13 health facilities of the Centre Region of Cameroon, from April through August 2018. Adherence was evaluated using a composite of both self-reported and pill count assessments. Risk factors of non-adherence were assessed using the socio-ecological model and p<0.05 were considered statistically significant. Results: Mean age was 14.63 (±2.89) and 55.9 % (224) were female. Rate of adherence was 25.2% (composite-assessment), 38.2% (pill-count) and 60.6% (self-reported). Following the composite-assessment, non-adherence was significantly higher in: vertically vs. horizontally infected adolescents (OR 4.24; 95% CI: 2.16-8.33, p<0.001); facilities with combined adult/adolescent vs. specialized adolescent care (0.32; 95% CI: 0.20-0.52, p<0.001); living beyond 5 km from the heath facility (OR 1.99; 95% CI: 1.26-3.15, p=0.003; inconvenient clinic appointments (OR 3.03; 95% CI: 1.78-5.16, p<0.001); Following multivariate analysis, non-adherence was associated with “living beyond 5 km from the heath facility” (OR 1.84, 95% CI: 1.01-3.33, p=0.045); “adolescents taking medication in the same service with adult” (OR 0.11, 95% CI: 0.03-0.35, p<0.001), managed at a rural health facility (OR 4.29, 95% CI: 1.84-9.96, p=0.001) and not counseled regularly (OR 0.02, 95% CI: 0.01-0.36, p=0.007). Conclusion: In the Centre region of Cameroon, about three-quarters of adolescents might be non-adherent to ART. Interventions towards improved adherence should focus on adolescents managed at the rural health facility and with vertical HIV-infection. Furthermore, convenient clinic appointments, creation of friendly adolescent healthcare centres and decentralising HIV-adolescent care in rural settings would improve adherence to ART program.

Keywords

adolescents, HIV/AIDS, ART, predictors, non-adherence and centre region of yaounde

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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