Background: Highly Active Antiretroviral therapy (HAART) in children in Africa has resulted in improved survival and quality of life. However, excellent adherence is one of the most important factors in determining treatment success and preventing resistance. This study determines factors associated with adherence to HAART among HIV-infected children in Kano, Nigeria.
Method: A cross-sectional study using structured questionnaire was conducted at the PEPFAR/HIV clinic in Aminu Kano Teaching Hospital, Nigeria. The study population consisted of children (and their caregivers) who had been taking ART and who access care at the clinic from May to June 2010.
Results: A total of 122 children were included in the study. 64% were males. 80 children (65.6%) were adherent to antiretroviral drugs for the preceding 7 days before the interview. Children whose caregivers reported no missed doses in the previous week (adherent) were more likely to have an HIV viral load <400copies/ml (75% vs. 45%, P= 0.0001, OR= 0.23, CI: 0.09-0.54). Children whose caregivers reported missing at least one clinic appointment in the last six months are more likely to be non adherent (p= 0.0001, OR= 49.92, CI: 10.60- 235.08). Similarly children whose caregivers are married are more likely to be adherent than those who are not (p=0.001, OR=0.07, CI: 0.02 – 1.33), and children whose caregivers timed their administration of medication to meal times are more likely to be adherent than their counterparts whose administration of medications is not related to meal time (p=0.007, OR= 0.10, CI: 0.02 – 0.53).
Conclusion: Adherence to HAART is positively correlated with no missed clinic appointments, with caregivers being married and administration of medication with mealtimes. Excellent adherence in the previous week is also significantly related to having undetectable viraemia. Adherence intervention by assessing clinic attendance, missed doses and dosing with mealtimes is recommended in this setting.