Factors influencing anti-retroviral drug adherence in HIV infected children attending Kericho District Hospital, Kenya

Abstract

Objective: To identify factors influencing anti-retroviral (ARV) drug adherence by HIV infected children aged 3 to 14 years attending Kericho District Hospital (KDH), Kenya.

Design: A cross-sectional study

Setting: Kericho District Hospital, Kenya

Subjects: Two hundred and thirty ( 230) HIV infected children aged 3 to 14 years under caregivers who had been on ARV treatment for at least three months before study as verified by clinicians.

Results: A total of 230 children aged between 3 and 14 years (mean age was 8.5 years ±3.2SD) were enrolled. Caregivers were aged between 16 and 90 years (mean age 34.6 years ± 10.4 SD). Majority, 178 (77.4%), of the caregivers were female and 137 (59.6%) were biological parents. ARV drug adherence levels, based on various methods of assessment, were sub-optimum, varied from 56.1% based on time of taking drugs, 49.1% based on pharmacy drug refills, 45.7% based on clinic appointments to 27.0% by pill counts.The key factors associated with adherence based on time of taking drugs were: caregiver being away from home (p=0.0010), caregiver forgetting to give drugs to the child (p=0.020), lack of disclosure of the child’s HIV infection status (p=0.0080) and side effects experienced by the child (p=0.0120), lack of knowledge on treatment (p=0.0030) and stigma (p=0.0470). Based on clinic appointments, the factors included caregiver being away from home (p=0.004), lack of disclosure of the child’s HIV infection (p=0.0000), side effects experienced by the child (p= 0.0030), stigma (p=0.0070) and transport cost (p=0.0240).

Conclusion: The most important adherence factors among children were: caregiver being away from home, caregiver forgetting, lack of disclosure, child experiencing side effects, lack of knowledge and skills in managing the disease, stigma and transport costs to hospital.