Adherence to Highly Active Antiretroviral Therapy and Its Correlates among HIV Infected Pediatric Patients in Addis Ababa, Ethiopia

BACKGROUND: The introduction of combination antiretroviral therapy (ART) including protease inhibitors has resulted in striking reductions in HIV-related mortality. Despite increased availability of antiretroviral therapy (ART), children remain a neglected population group. Failure to adhere very closely to the regimens appears to be related to continued viral replication, treatment failure and the emergence of drugresistant strains of HIV. Adherence to ART among children and its correlates is not studied in Ethiopia. OBJECTIVE: To assess the rates and determinants of adherence to ARV therapy in HIV-infected children who are receiving HAART in Addis Ababa, Ethiopia in 2008. METHODS: A cross sectional study, was conducted in five hospitals in Addis Ababa from February 18April 28, 2008. The study population was parents /caretaker and index children who were following ART in the health facilities. Structured questionnaire and key informants interview guide were used for data collection. Data was entered in to computer and univariate and multivariate analysis were carried out using SPSS statistical software version 12.0.1. RESULTS: A total of 390 children respondents were included in the study with response rate of 91%. The majority 205 (52.6%) of the children were above 9 years. Fifty five percent of the children were Girl’s. A total of 339(86.9%) children were adherent to antiretroviral drugs in the past 7 days before the commencement of the interview. Among many variables, caregivers didn’t paid for child treatment at the initial phase before initiating ART treatment [OR=0.387,95%CI=0.162,0.924], nutritional support for the children [OR=0.337,,95%CI=0.143,0.795],taking co-trimoxazole’s medication/syrup besides ARVs [OR=3.64,95%CI =1.236,10.74], child didn’t know about his/her Serostatus [OR=2.533,95%CI =1.236,5.194] , child didn’t perceive awareness about the health problem of the caregiver [OR= 2.448,95%CI =1.245,4.813] were independently associated with adherence. CONCLUSION: Adherence to HAART in children in Addis Ababa was higher than other countries. However, there are still significant numbers of non-adherent to HAART. Nutritional supports, disclosure of child Sero-status, uses of co-trimoxazole’s as prophylaxis are essential to improve adherence to ART among children