An investigation of adherence to antiretroviral therapy using caregiver reports in children aged 2-14 years in Lagos Nigeria

Abstract

Background/Objective: The introduction of antiretroviral therapy (ART) has shown a tremendous reduction in HIV-related mortality and morbidity in people living with HIV / AIDS. Adherence is essential to achieve the success of ART. In children, the caregivers play very key roles and understanding the factors that affect adherence to antiretroviral therapy is important for successful and sustained viral load suppression. The objective of the study was to evaluate the adherence to antiretroviral therapy and its associated factors using reports from caregivers of children aged 2-14 years.

Design, Setting and subjects: This prospective cross-sectional study involved 164 caregivers of children living with HIV and who were receiving antiretroviral therapy for more than three months. The study was carried out at the pediatric human immunodeficiency (HIV) clinic of the Lagos University Teaching Hospital (LUTH) from June to August 2017.

Interventions: Adherence was assessed by caregiver reports using a pretested questionnaire. Descriptive analyses including mean for numerical variable, frequencies and proportions for categorical variables were performed. Chi-square test was used to assess the association between gender, education level of caregivers and adherence. The level of significance was p<0.05

Main outcome measure: Adherence to antiretroviral therapy and its associated factors

Results: Ninety-one percent of the caregivers were females. Eighty two percent could read and write and sixty eight percent were mothers of the children. The caregivers felt that availability of drugs (59%) and fear of death (28%) were the commonest factors responsible for good adherence while pill burden (37%), stigmatization (32%) and forgetfulness (31%) were the commonest reasons for poor adherence. Gender and educational level were not significantly associated with adherence. (Pearson Chi-Square = 2.481 and p-value < 0 .05).

Conclusion: The role of the caregiver is very important to maintain good adherence levels and therefore treatment success. Health education on the importance of adherence, antiretroviral therapy should be improved and targeted at caregivers of children to improve adherence.