O-41 Adherence to antiretroviral therapy among adolescents living with HIV

Methods: During August-October 2021, we conducted a cross-sectional study on adherence (no missed doses in preceding four days) among adolescents 10-18 years attending three outpatient departments in the Kingston Metropolitan Area. Adherence factors were evaluated using a selfadministered, interviewer-assisted structured questionnaire. Biochemical and clinicopathological information were retrieved from patients’ medical records. Multivariate logistic regression was used to determine likelihood of adherence for given adherence factors.

Results: Of 65 participating clients, 92.3 % were perinatally infected, mean (SD) age 15.4 (2.0) years and 61.5% were female. Overall self-reported adherence was 66.1% (43/65) and higher among adolescents in residential care versus family care (p = 0.002). Median (IQR) viral load 19 copies/ml/103 (IQR 19-51) was lower (p = 0.010) and median (IQR) CD4+ count 701 cells per µL (IQR 501-1052) higher (p = 0.016) among adolescents in residential care compared to family care. Adherence was 4X more likely among adolescents at UHWI (OR = 4.53, 95% CI (1.25, 16.43), knowledgeable about ARVs (OR = 4.31, (1.09,17.04), and with reduced appointments due to COVID-19 pandemic (OR = 5.36, (1.09, 26.41) and 4X less likely if cared for by relatives, experiencing side effects, higher pill burden or hospitalized with complications.

Conclusion: Medication, caregiver-related and health system management factors are both enablers and barriers of adherence for ALHIV, and the importance of caregivers’ support, treatment literacy and simplified treatment regimens are highlighted.