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UNAIDS. 2016. Global AIDS Update. Geneva, Switzerland: The Joint United Nations Programme on HIV/AIDS. Available at: http://www.unaids.org/en/resources/documents/2016/Global-AIDS-update-2016. Assessed on 3th November 2018

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Article

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

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


American Journal of Public Health Research. 2019, Vol. 7 No. 4, 126-136
DOI: 10.12691/ajphr-7-4-1
Copyright © 2019 Science and Education Publishing

Cite this paper:
Alice Ketchaji, Felix Assah, Joseph Fokam, Elvis Asangbeng Tanue, Francisca Monebenimp, 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.

Correspondence to: Alice  Ketchaji, Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon. Email: nkouki2002@yahoo.fr

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.

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