FACTORS ASSOCIATED WITH ADHERENCE TO ANTIRETROVIRAL THERAPY AMONG THE YOUTH RECEIVING LONG-TERM ART IN SELECTED HEALTH CENTRE IVS IN ISINGIRO DISTRICT, UGANDA
TL;DR
ART adherence among youth is shaped by an interacting web of family support, treatment fatigue, and health-system efficiency, rather than by any single dominant factor.
Abstract
Introduction: Optimal adherence to antiretroviral therapy (ART) is essential for viral suppression, yet the factors driving adherence among youth in rural Ugandan settings remain incompletely documented. This article, drawn from a wider study, examined the factors associated with ART adherence among youth receiving long-term ART in selected Health Centre IVs in Isingiro District, Uganda. Methods: A cross-sectional design employing a mixed-methods approach was used. Quantitative data were collected from 243 youths aged 18–30 years on ART using a structured questionnaire, while qualitative data were obtained from three counsellors and three peer educators through in-depth interviews. Bivariate ordinal logistic regression screened variables at p<0.10 within four factor domains (social support, individual, drug-related, and health facility), and significant variables were entered into domain-specific multivariate binary logistic regression models. Qualitative data were analysed thematically. Results: Active peer co-engagement in HIV services and open medication communication were the strongest social predictors of adherence. Absence of a family drug/pill companion (AOR=0.22, 95%CI=0.11–0.47, p=0.001) and alcohol consumption were the leading individual-level predictors. Treatment fatigue, operationalised as second thoughts about continuing ART, was the dominant drug-related predictor (AOR=3.58, 95%CI=1.71–7.50, p=0.001). Delayed attendance at the health facility was the only significant health-system predictor (AOR=4.32, 95%CI=1.29–14.41, p=0.017). Conclusion: ART adherence among youth is shaped by an interacting web of family support, treatment fatigue, and health-system efficiency, rather than by any single dominant factor. Recommendation: Programmes should formalise family pill-companion support, integrate motivational counselling to address treatment fatigue, and prioritise appointment-system reforms to reduce facility delays.