Abstract
Little is known about adherence to antiretroviral therapy (ART) among adolescents in sub-Saharan Africa, where the majority of the world’s HIV-positive adolescents reside. We assessed individual, household, and HIV self-management characteristics associated with a 48-hour treatment gap in the preceding 3 months, and a pharmacy medication possession ratio (MPR) that assessed the number of ART pills dispensed divided by the number of ART pills required in the past 6 months, among 285 Zambians, ages 15–19 years. Factors significantly associated with a 48-hour treatment gap were being male, not everyone at home being aware of the adolescent’s HIV status, and alcohol use in the past month. Factors associated with an MPR < 90% included attending the clinic alone, alcohol use in the past month, and currently not being in school. Findings support programs to strengthen adolescents’ HIV management skills with attention to alcohol use, family engagement, and the challenges adolescents face transitioning into adulthood, especially when they are no longer in school.
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Acknowledgements
We are grateful to the adolescents who participated in this study. We appreciate the support and guidance of the staff at the health facilities where this research was conducted. We also thank Samuel Field of FHI 360 for his statistical advice and Suzanne Fischer for her technical writing and editing skills.
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The contents do not necessarily reflect the views of USAID or the United States government.
Funding
This work was made possible by the generous support of the American people through the U.S. Agency for International Development (USAID). Financial assistance was provided by USAID to FHI 360 under the terms of the Preventive Technologies Agreement No. GHO-A-00-09-00016-00. This publication was made possible with help from the Johns Hopkins University Center for AIDS Research, an NIH funded program (P30AI094189), which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Denison, J.A., Packer, C., Stalter, R.M. et al. Factors Related to Incomplete Adherence to Antiretroviral Therapy among Adolescents Attending Three HIV Clinics in the Copperbelt, Zambia. AIDS Behav 22, 996–1005 (2018). https://doi.org/10.1007/s10461-017-1944-x
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DOI: https://doi.org/10.1007/s10461-017-1944-x