ANTIRETROVIRAL TREATMENT ADHERENCE AMONG CHILDREN ATTENDING PAEDIATRIC HIV CLINIC AT FEDERAL MEDICAL CENTRE OWERRI, IMO STATE NIGERIA

Abstract

Antiretroviral treatment (ART) adherence in Paediatrics is very important as it is the fulcrum
around which revolves the success or failure of HIV treatment. This study was undertaken to
determine the level of ART adherence and factors influencing it among HIV-infected
children attending the Paediatric HIV clinic at FMC Owerri, Imo state.
This prospective, hospital-based cross-sectional study was carried out from September to
December 2013, using self-report method of adherence assessment with a validated
interviewer-administered questionnaire. Two hundred and ten (210) children who had been
on ART for at least 4 months were enrolled into the study. Self-report method was used in
assessing adherence.
Ninety-one percent (91%) of the children studied had 95% ART adherence level. Among
the 210 recruited subjects, the age range was 10-179 months with a mean age of 84.73
months, and standard deviation, SD ±39.84. There were 108 male subjects and 102 female
subjects giving a male: female percentage of 51.4% and 48.6% respectively. Adherence level
in the female subjects was 92% while it was 90% in the male subjects. The difference is not
statistically significant, (p value 0.075).
The factors influencing adherence in this study include subject’s educational level (X2
10.81, p 0.004), duration of treatment (X2 29.91, p 0.001), who administers the ART (X2
12.60, p 0.005) and orphan status (X2 23.30, p 0.001). The caregiver’s age also influenced
ART adherence in this study (X2 15.96, p 0.005). The most encouraging factor for adherence
was ‘not falling sick as before’ while ‘fear of being known to have the disease’ (stigma), was
the most discouraging factor (barrier).
In conclusion, the adherence level of 91% is comparable to levels seen in other population
of children. The most important factors influencing adherence in this study are subject’s
educational level, duration of treatment, who administers the ART, orphan status and
caregiver’s age. It is therefore recommended that there should be sustained provision of
ARVs free, available and accessible to HIV-infected children; and the barrier ‘stigma’ should
be seriously addressed to demystify it.

ANTIRETROVIRAL TREATMENT ADHERENCE AMONG CHILDREN ATTENDING PAEDIATRIC HIV CLINIC AT FEDERAL MEDICAL CENTRE OWERRI, IMO STATE NIGERIA