Assessment of adherence to antiretroviral therapy, associated factors, and relationship to CD4 cell count recovery among HIV-positive adolescents
Background: Adherence to antiretroviral therapy (ART) in HIV-positive adolescents (HPAs) is an enormous challenge in pediatric HIV management. Suboptimal adherence (OA) encourages treatment failure and HIV transmission. Several factors are inimical to OA, among HPA. Objective: The factors which infl...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Nigerian Journal of Medicine |
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| Online Access: | http://www.njmonline.org/article.asp?issn=1115-2613;year=2021;volume=30;issue=5;spage=592;epage=600;aulast=Ogbuefi |
| _version_ | 1818739353000607744 |
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| author | Nonso Anthony Ogbuefi Ebelechuku Francesca Ugochukwu Chinyere Ukamaka Onubogu Emeka Stephen Edokwe Kenneth Nchekwube Okeke |
| author_facet | Nonso Anthony Ogbuefi Ebelechuku Francesca Ugochukwu Chinyere Ukamaka Onubogu Emeka Stephen Edokwe Kenneth Nchekwube Okeke |
| author_sort | Nonso Anthony Ogbuefi |
| collection | DOAJ |
| description | Background: Adherence to antiretroviral therapy (ART) in HIV-positive adolescents (HPAs) is an enormous challenge in pediatric HIV management. Suboptimal adherence (OA) encourages treatment failure and HIV transmission. Several factors are inimical to OA, among HPA. Objective: The factors which influence adherence to ART in HPA accessing care in Nnewi, Nigeria, were determined. Subjects and Methods: One hundred and fifty HPAs, aged 10–19 years, who had been on ART for at least 6 months were recruited; 75 each for groups 10–14 and 15–19 years. Sociodemographic data were collected using interviewer-administered questionnaires. Relevant clinical data were retrieved from medical records, and current CD4 cell counts assayed. Results: There were 77 males and 73 females. OA to ART was defined as intake of ≥95% of antiretrovirals over a given period. Using pill count (PC), 74.7% (112/150) had OA. Using the preceding 28-day self-report (P28DSR), 84.0% (126/150) had OA, while for the preceding seven-day self-report (P7DSR), it was 89.3% (134/150). Factors significantly associated with sub-OA were tertiary education, missed clinic visits, travel time to facility ≤1 h, persistent feeling of sadness, and fear of death. Subjects with OA had a significantly higher rate of CD4 cell count recovery compared to those having sub-OA. Conclusion: Sub-OA is common in HPA and can be assessed with a combination of PC and preceding P28DSR, in resource-poor settings. As OA is crucial to CD4 cell count recovery, the latter can be useful in monitoring adherence in HPA. |
| first_indexed | 2024-12-18T01:23:29Z |
| format | Article |
| id | doaj.art-13c09fecc8864619b57c55459212d544 |
| institution | Directory Open Access Journal |
| issn | 1115-2613 |
| language | English |
| last_indexed | 2024-12-18T01:23:29Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Nigerian Journal of Medicine |
| spelling | doaj.art-13c09fecc8864619b57c55459212d5442022-12-21T21:25:46ZengWolters Kluwer Medknow PublicationsNigerian Journal of Medicine1115-26132021-01-0130559260010.4103/NJM.NJM_121_21Assessment of adherence to antiretroviral therapy, associated factors, and relationship to CD4 cell count recovery among HIV-positive adolescentsNonso Anthony OgbuefiEbelechuku Francesca UgochukwuChinyere Ukamaka OnuboguEmeka Stephen EdokweKenneth Nchekwube OkekeBackground: Adherence to antiretroviral therapy (ART) in HIV-positive adolescents (HPAs) is an enormous challenge in pediatric HIV management. Suboptimal adherence (OA) encourages treatment failure and HIV transmission. Several factors are inimical to OA, among HPA. Objective: The factors which influence adherence to ART in HPA accessing care in Nnewi, Nigeria, were determined. Subjects and Methods: One hundred and fifty HPAs, aged 10–19 years, who had been on ART for at least 6 months were recruited; 75 each for groups 10–14 and 15–19 years. Sociodemographic data were collected using interviewer-administered questionnaires. Relevant clinical data were retrieved from medical records, and current CD4 cell counts assayed. Results: There were 77 males and 73 females. OA to ART was defined as intake of ≥95% of antiretrovirals over a given period. Using pill count (PC), 74.7% (112/150) had OA. Using the preceding 28-day self-report (P28DSR), 84.0% (126/150) had OA, while for the preceding seven-day self-report (P7DSR), it was 89.3% (134/150). Factors significantly associated with sub-OA were tertiary education, missed clinic visits, travel time to facility ≤1 h, persistent feeling of sadness, and fear of death. Subjects with OA had a significantly higher rate of CD4 cell count recovery compared to those having sub-OA. Conclusion: Sub-OA is common in HPA and can be assessed with a combination of PC and preceding P28DSR, in resource-poor settings. As OA is crucial to CD4 cell count recovery, the latter can be useful in monitoring adherence in HPA.http://www.njmonline.org/article.asp?issn=1115-2613;year=2021;volume=30;issue=5;spage=592;epage=600;aulast=Ogbuefiadherenceantiretroviral therapycd4 cell count recoveryhiv-positive adolescents |
| spellingShingle | Nonso Anthony Ogbuefi Ebelechuku Francesca Ugochukwu Chinyere Ukamaka Onubogu Emeka Stephen Edokwe Kenneth Nchekwube Okeke Assessment of adherence to antiretroviral therapy, associated factors, and relationship to CD4 cell count recovery among HIV-positive adolescents Nigerian Journal of Medicine adherence antiretroviral therapy cd4 cell count recovery hiv-positive adolescents |
| title | Assessment of adherence to antiretroviral therapy, associated factors, and relationship to CD4 cell count recovery among HIV-positive adolescents |
| title_full | Assessment of adherence to antiretroviral therapy, associated factors, and relationship to CD4 cell count recovery among HIV-positive adolescents |
| title_fullStr | Assessment of adherence to antiretroviral therapy, associated factors, and relationship to CD4 cell count recovery among HIV-positive adolescents |
| title_full_unstemmed | Assessment of adherence to antiretroviral therapy, associated factors, and relationship to CD4 cell count recovery among HIV-positive adolescents |
| title_short | Assessment of adherence to antiretroviral therapy, associated factors, and relationship to CD4 cell count recovery among HIV-positive adolescents |
| title_sort | assessment of adherence to antiretroviral therapy associated factors and relationship to cd4 cell count recovery among hiv positive adolescents |
| topic | adherence antiretroviral therapy cd4 cell count recovery hiv-positive adolescents |
| url | http://www.njmonline.org/article.asp?issn=1115-2613;year=2021;volume=30;issue=5;spage=592;epage=600;aulast=Ogbuefi |
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