Determinants of Non-Adherence to Antiretroviral Therapy among HIV Positive Adolescents in a Tertiary Hospital in North Central Nigeria

Abstract

Aim: The aim of this present study was to determine the prevalence of non-adherence to ART and identify the determinants of non-adherence among HIV-positive adolescents attending a tertiary hospital in north central Nigeria. Non-adherence to antiretroviral therapy (ART) is a major problem in the care of HIV positive adolescents on antiretroviral treatment because it is thought to impact negatively on their treatment. The prevalence of non-adherence to antiretroviral therapy among adolescent in sub-Saharan Africa is between 40 and 50%. Nigeria has a prevalence of 58%. Study Design: Using a facility-based cross-sectional study, Place and Duration of the Study: At sexually transmitted infections clinic, Federal Medical Centre Makurdi, Benue State, Nigeria from January 2023 to October 2024. Methodology: A total of 417 consenting HIV-positive adolescents aged 10-19 years, who had been on ART for at least six months, were recruited using convenience sampling. Data collection included socio-demographic characteristics, the eight-item Morisky medication adherence scale (8-mmas), and an eight-item self-developed scale to assess barriers to adherence. Data analysis was conducted using the statistical package for social sciences (SPSS) software (version 23.0). Socio-demographic characteristics, prevalence of non-adherence, and determinants of non-adherence were reported as percentages. Chi-square, fisher test, and logistic regression were employed to identify determinants of non-adherence, with a significance level set at p < 0.05. Results: The prevalence of non-adherence to ART among the study participants was 77.7%. Non-adherence was significantly associated with age, education level, occupation, ethnicity, and fear of stigmatization. Conclusion: Enhanced adherence counseling, targeted interventions for at-risk adolescents, and a comprehensive approach that includes adherence assessment for those fearing stigmatizations and with unsuppressed viral loads are recommended. These strategies may improve long-term therapeutic success and facilitate the transition from pediatric to adult care in this population.