Factors associated with self-reported adherence among adolescents on antiretroviral therapy in Zimbabwe

Abstract

Nonadherence to medication is the key obstacle to human immunodeficiency virus (HIV) treatment success. The group at highest risk of nonadherence is adolescents, but relatively little is known about risk factors for and protective factors against poor adherence in this age group. We undertook a cross-sectional study of 262 HIV-infected adolescents aged 10–19 years on antiretroviral therapy at two clinics in Harare, Zimbabwe, to investigate personal and system-level factors associated with optimal self-reported adherence. Suboptimal adherence was common with only 101 (39%) reporting “excellent” adherence. Having the guardian present at each clinical encounter, comfort with asking questions to the health provider and participating in group sessions led by a professional facilitator were all significantly associated with excellent adherence (p < 0.05). Strengthening the parent–child dyad and professional-led groups as strategies to improve adherence should be evaluated.

Keywords:

• HIV-1
• antiretroviral therapy
• adolescents
• medication adherence

Supplementary material

Supplementary content is available via the “Supplementary” tab on the article’s online page (http://dx.doi.org/10.1080/09540121.2014.969676).

Additional information

Funding

Dr Lowenthal's effort was supported by NIH [grant number K23 MH095669], and Dr Gross' effort was supported by the Penn Center for AIDS Research (CFAR), an NIH-funded program [grant number P30 AI 045008].