Factors Influencing Adherence to Antiretroviral Therapy among Youth (15-24 Years) in Selected Health Facilities in Nyeri County, Kenya

Abstract

The antiretroviral therapy combinations introduction in 1996 disrupted the natural course of the HIV/AIDS infection. In fact, ARVs induced an effective reduction in the morbidity and incidence of new cases; they have changed the prognosis of infected patients by conferring on this pathology a chronic character. However, ARV treatment requires rigorous adherence. Adherence constitutes the main factor for the success of ART, a fundamental element of the HIV infection response. The danger of low adherence is the emergence of resistance to HIV. Understanding factors that influence positively or negatively the adherence is essential to maximize viral suppression and reduce mortality. Globally, there are numerous reported cases of non-adherence. Adolescents and young people (15-24) are the epicentre of the pandemic, according to UNAIDS, with 30 percent of new HIV infections happening in this age group in 2019`. Nyeri County is one of the counties that have an emerging epidemic as evidenced by the consistent in rise in their HIV burden. The study’s main objective was to determine factors influencing adherence to antiretroviral therapy among youth aged 15-24 years attending the various selected health facilities in Nyeri County. The study used a cross-sectional descriptive design and an interviewer-administered questionnaire to collect data in 3 health facilities: Karatina district hospital, Nyeri referral hospital, and Tumutumu PCEA hospital. A focus group discussion approach was incorporated as well. The participants in the research were patients that had been on ART for at least for 6 months, selected via probability sampling. The examined variables were demographic factors, economic, socio-cultural, and ART regimen factors as the independents, and adherence to ART as the dependents variable. The Statistical Package for Social Sciences (SPSS software version 25) was used for quantitative data analysis, whereas the qualitative data obtained from the open-ended questions were analysed with the aid of the conceptual content analysis and presented in quotes. Results show that the proportion of young people of the 15 to 24 years age bracket, with undetectable viral load, who are adherent is 67%. The only demographic factor which is seemed to be associated with adherence is gender (𝑋2=5.810, p=0.016). Economic factors such as occupation (X2=5.33, P=0.017), and balanced diet (𝑋2= =9.343, p=0.002) were found to be significant predictors of the viral load. Stigma (𝑋2 =49.811 P=0.0001), social support (X2=8.147, P=0.0004), social avoidance (𝑋2=13.925, P= 0.0001), beliefs such as thinking stop the ARVs (𝑋2=8.706, P=0.003), denial of the condition (𝑋2= 8.472, P= 0.004) are also good predictors of the adherence among youth. The ART regimen factors like the count of pills to swallow per day are also linked to adherence (𝑋2=0.0816, P= 0.04). To improve adherence to ART among youth, the study recommends that the community should provide the necessary support to young people living with HIV by banishing stigmatizing and discriminatory practices and remarks. Continuous strengthening of health education through operation triple zero (OTZ) and counselling is important for improvement of adherence.