The Effect of Adherence to Antiretroviral Therapy on Viral Suppression among HIV-Infected Adolescents and Young Adults (AYA) Seen at the Korle Bu Teaching Hospital (KBTH)

Abstract

Background Adolescents and young adults have gained remarkable attention among PLWHIV because they constitute the only group where HIV-associated mortality is going up despite the introduction of HAART. The aim of the study was to describe level of adherence to ART and its related factors and viral suppression among AYA population at the Fevers Unit of the Korle Bu Teaching Hospital. Methods This was a cross-sectional study involving 136 study participants who have been on ARV for 2 or more years at the treatment center. A structured questionnaire was used for data collection. Self – reported adherence was assessed using MMAS-8 and announced pill count done by a trained Pharmacist. Viral load levels were retrieved from latest medical records. Results Out of the 136 study participants, prevalence of adherence was 78.7% and 93.8% for self –report (MMAS-8) and by pill count respectively. Prevalence of viral suppression (<400copies/ml) among the 110 who had viral load retrieved from medical records was 68.2%. Self –reported adherence was the only independent predictor of viral suppression. Those with medium adherence score were 5.3 times more likely to be virally suppressed compared to their counterpart with low adherence scores (OR=5.3, p=0.003, 95% CI, 1.74 -16.34). Also those with high adherence scores were 8.4 times more likely to be virally suppressed than those with low adherence scores (OR=8.4, p=0.003, 95% CI, 2.11-33.48). The commonest reason for missing ARV was forgetfulness. Conclusion Medication adherence was high among the AYA population; however, viral suppression was low. Efforts must be made by all stakeholders involved in HIV care among this special group of persons to increase viral suppression rates.