Assessment of Factors That Influence Adherence to Antiretroviral Therapy in Adolescents between 10-19 Years Living With HIV Infection in Blantyre Urban
| dc.contributor.author | Chisi, Kondwani D. | |
| dc.date.accessioned | 2022-06-13T06:48:34Z | |
| dc.date.available | 2022-06-13T06:48:34Z | |
| dc.date.issued | 2022-05-12 | |
| dc.description.abstract | The Human immunodeficiency virus (HIV) is one of the significant pandemic of the modern era which causes Acquired Immunodeficiency Syndrome (AIDS)(1). HIV has affected all countries globally, and in parts of the world is still a main source of mortality(1). Malawi is geared to ensure that all necessary HIV and AIDS control measures are implemented with an aim of reducing the impact of HIV and AIDS and eliminate HIV as a public health threat in 2030 in line with the 2016 United Nations General Assembly Political Declaration on HIV and AIDS(2). Problem: Despite the tremendous advancement in survival and marked reduction in transmission through antiretroviral therapy (ART) (3) sub-optimal adherence to ART and poor retention in care continue to pose a major challenge to the effectiveness of ART, care, and success of HIV treatment programmes across the world. The treatment failure rate in adolescents living with HIV (ALHIV) is higher than in adults living with HIV(4). Besides, adolescents are the only age group where HIV-related mortality is going up (5). Hence, the solution is needed in this susceptible group which shows a 50% reported increase in AIDS-related mortality, relative to a 30% decline in the general population (4). Children and adolescents have lower reported treatment coverage, adherence to treatment and viral suppression rates than older age groups(6). ALHIV have poorer outcomes than HIV-infected adults; for instance, delayed initiation of antiretroviral treatment (ART), poorer retention in care and poorer rates of viral suppression(7). Recent data show an increase in AIDS-related deaths among the ALHIV, making AIDS the major cause of death in adolescents in SSA and the second leading cause of death among adolescents internationally(7). However, long term optimal adherence to ART are essential for sustained viral suppression, thereby preventing drug resistance and disease progression(8). The recommended optimal adherence to antiretroviral therapy by the World Health Organisation (WHO) is ≥95%(9). In contrast to WHO’s recommendation, the average adherence rate to ART among ALHI at Umodzi Family Centre (UFC) which is located within the campus of Queen Elizabeth Central Hospital (QECH) is equal to 90%, evidenced by the data-base and ART registers. Given the gap, it is vital to carry out similar studies in Blantyre Urban in order to determine factors that might be enablers or barriers to optimal adherence to ART among the ALHIV. Objectives: The broad objective of this study is to assess the factors that influence adherence to ART among adolescents between 10-19 years living with HIV in Blantyre Urban. The specific objectives include the following: 1. To explore health system factors that influence adherence to ART 2. To identify the social-economic factors that may influence adherence to ART 3. To identify socio-cultural factors that maximize adherence to ART. Methodology This is a descriptive qualitative study to be conducted in order to assess the factors that influence adherence to ART among adolescents living with HIV in Blantyre Urban. The In-Depth Interviews (IDIs) and Focus Group discussions(FGDs) (10) will be used in this study. The former will be used because it guarantees the deep scope of understanding for social factors (11). The study will be conducted at Umodzi Family Centre (UFC) within Queen Elizabeth Central Hospital (QECH) campus in Blantyre. The study population will include all HIV-infected adolescents aged 10-19 whose parents have consented to the study. In this study, data collection tool will include the pretested interview and discussion guides that will be developed based on the study objectives. The sample size will be 34 and the study participants will be purposively selected which will comprise of adolescents for in-depth interviews following the study’s eligibility criteria. The study will collect data at UFC setting using in depth interviews (IDI) and Key Informant Interviews (KIIs). The storage of collected data will be in secured computer data base that have a pass word and only limited access to key research team will be provided. Data analysis will be done using deductive and inductive thematic content analysis. Informed consent will be got from each and every study participant before enrollment in the study. In case of children between the age of 10 -15, caregivers will sign consent forms on behalf of their children. Each participant will then choose her/his pseudonym that will be used for the study. Confidentially will be ensured throughout the study and thereafter. Ethical approval will be sought from the College of Medicine Research and Ethics Committee (COMREC). Expected Findings: The findings to be presented will be derived from the answers to research questions that will be given to the study participants. Evidence will take the form of quotations from interviews and passages from observations. Critical analysis of the findings and counterevidence (evidence that contradicts the primary finding) will be done to come up with a logical presentation of the research findings. Dissemination of results: Research results will be disseminated in writing and presentations as feedback made to health care workers at Umodzi Family Centre and the management of Queen Elizabeth Central Hospital (QECH). Recommendations will be made to various level of decision makers at QECH and the key implementing partner (Light House) on improvements that need to be made to understand better the challenges of adherence to ART among adolescents and strategize appropriate interventions to address challenges and eventually maximize the benefits of antiretroviral drugs to adolescent patients. The researcher intends to communicate to overall policy holder, the Department of HIV & AIDS. The results of my evaluation will be disseminated on the University's website, conferences organized periodically by the Kamuzu University of Health Sciences (KUHeS) and through articles published in peer-reviewed journals. | en_US |
| dc.description.sponsorship | Self sponsored | en_US |
| dc.identifier.uri | http://rscarchive.kuhes.ac.mw/handle/20.500.12988/1006 | |
| dc.publisher | Kamuzu University of Health Sciences | en_US |
| dc.relation.ispartofseries | Ethics Approval;P.02/22/3585 | |
| dc.subject | Adherence to ART for adolescents in Blantyre | en_US |
| dc.title | Assessment of Factors That Influence Adherence to Antiretroviral Therapy in Adolescents between 10-19 Years Living With HIV Infection in Blantyre Urban | en_US |