Factors Influencing Adherence to Antiretroviral Therapy among Youth (15-24 Years) in Selected Health Facilities in Nyeri County, Kenya
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Date
2021-10Author
Irakoze, Huguette
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
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.
Publisher
KeMU