Factors Related to Incomplete Adherence to Antiretroviral Therapy among Adolescents Attending Three HIV Clinics in the Copperbelt, Zambia

Abstract

Little is known about adherence to antiretroviral therapy (ART) among adolescents in sub-Saharan Africa, where the majority of the world's HIV-positive adolescents reside. We assessed individual, household, and HIV self-management characteristics associated with a 48-hour treatment gap in the preceding 3 months, and a pharmacy medication possession ratio (MPR) that assessed the number of ART pills dispensed divided by the number of ART pills required in the past 6 months, among 285 Zambians, ages 15-19 years. Factors significantly associated with a 48-hour treatment gap were being male, not everyone at home being aware of the adolescent's HIV status, and alcohol use in the past month. Factors associated with an MPR < 90% included attending the clinic alone, alcohol use in the past month, and currently not being in school. Findings support programs to strengthen adolescents' HIV management skills with attention to alcohol use, family engagement, and the challenges adolescents face transitioning into adulthood, especially when they are no longer in school.

Factors Associated with Non-Adherence to Antiretroviral Therapy among HIV-Infected Adolescents at Pediatric Department of Yopougon University Hospital, C&#244;te d’Ivoire

“…This result was also found in a study conducted in Zambia among 15 -19-years old adolescents [20]. However, other studies have shown no significant difference between girls and boys [21].…”

Project YES! Youth Engaging for Success: A randomized controlled trial assessing the impact of a clinic-based peer mentoring program on viral suppression, adherence and internalized stigma among HIV-positive youth (15-24 years) in Ndola, Zambia

“…and "What were the most days in a row that you missed swallowing your drugs in the past three months?" [40,41]. A binary outcome was generated so that a participant was considered to not have a treatment gap if they said no to missing any full days of ART drugs in the past three months, or if they said yes and only missed one day.…”

“…Internalized stigma. Internalized stigma was measured at both time points using three agree/disagree questions from the Internalized AIDS Stigma Scale (IA-RSS) [42], that have been used in a previous study among a population of HIV-positive adolescents in Ndola, Zambia [41]. This measure asks participants to either "agree" or "disagree" with each of the following three statements: (1) You feel guilty that you are HIV positive; (2) You are ashamed that you are HIV positive; and (3) You sometimes feel worthless because you are HIV positive.…”

“…This measure asks participants to either "agree" or "disagree" with each of the following three statements: (1) You feel guilty that you are HIV positive; (2) You are ashamed that you are HIV positive; and (3) You sometimes feel worthless because you are HIV positive. From this data, a binary outcome was generated with "1" indicating that the participant answered "agree" to at least two of the three questions, and "0" otherwise [41]. If answers to all three were missing, this outcome was considered missing.…”

Adolescents living with HIV in the Copperbelt Province of Zambia: Their reproductive health needs and experiences

“…In this paper, we present the results from a mixed-methods study that was conducted to inform programming for ALHIV in Zambia. Findings from this study have been published previously include perspectives from ALHIV on living with HIV and HIV self-management, an analysis of factors related to incomplete ART adherence, and characteristics of ALHIV who are on second-line ART treatment [ 12 – 14 ]. In this paper, we focus solely on the SRH needs of ALHIV from multiple perspectives, including adolescents themselves, their caregivers, and clinic providers.…”