Research article

Adherence to highly active antiretroviral therapy and its correlates among HIV infected pediatric patients in Ethiopia

Sibhatu Biadgilign¹ , Amare Deribew¹ , Alemayehu Amberbir² and Kebede Deribe³

¹Jimma University, Public Health Faculty, Department of Epidemiology and Biostatistics, Jimma, Ethiopia

²Addis Ababa University, School of Public Health, Butajira Birth cohort project, Addis Ababa, Ethiopia

³Fayyaa Integrated Development Association-NCMI, PEPFAR-New Partners Initiative, P.O. Box 19715 Addis Ababa, Ethiopia

author email corresponding author email

BMC Pediatrics 2008, 8:53doi:10.1186/1471-2431-8-53

Published:	6 December 2008

Abstract

Background

The introduction of combination antiretroviral therapy (ART) has resulted in striking reductions in HIV-related mortality. Despite increased availability of ART, children remain a neglected population. This may be due to concerns that failure to adhere appears to be related to continued viral replication, treatment failure and the emergence of drug-resistant strains of HIV. This study determines the rates and factors associated with adherence to Antiretroviral (ARV) Drug therapy in HIV-infected children who were receiving Highly Active Antiretroviral Therapy (HAART) in Addis Ababa, Ethiopia in 2008.

Methods

A cross-sectional study was conducted in five hospitals in Addis Ababa from February 18 – April 28, 2008. The study population entailed parents/caretaker and index children who were following ART in the health facilities. A structured questionnaire was used for data collection.

Results

A total of 390 children respondents were included in the study with a response rate of 91%. The majority, equaling 205 (52.6%) of the children, were greater than 9 years of age. Fifty five percent of the children were girls. A total of 339 children (86.9%) as reported by caregivers were adherent to antiretroviral drugs for the past 7 days before the interview. Numerous variables were found to be significantly associated with adherence: children whose parents did not pay a fee for treatment [OR = 0.39 (95%CI: 0.16, 0.92)], children who had ever received any nutritional support from the clinic [OR = 0.34 (95%CI: 0.14, 0.79)] were less likely to adhere. Whereas children who took co-trimoxazole medication/syrup besides ARVs [OR = 3.65 (95%CI: 1.24, 10.74)], children who did not know their sero-status [OR = 2.53 (95%CI: 1.24, 5.19)] and children who were not aware of their caregiver's health problem [OR = 2.45 (95%CI: 1.25, 4.81)] were more likely to adhere than their counterparts.

Conclusion

Adherence to HAART in children in Addis Ababa was higher than other similar setups. However, there are still significant numbers of children who are non-adherent to HAART.