Abstract
Antiretroviral therapy (ART) defaulting is a serious problem among youth accessing Human immunodeficiency virus (HIV) care services in Malawi. It leads to development of drug resistance, treatment failure and increased client mortality. This study aimed at assessing patient factors influencing ART defaulting amongst youth living with HIV enrolled on ART in Mzimba District. A quantitative, case-control design was employed, enrolling 411 youths living with HIV (n = 137 cases and n = 274 controls) attending an HIV care clinic. The cases and controls were allotted to the ART clinics proportionally to their number of ART clients. Random sampling techniques were used to recruit both ART defaulters and non-defaulters. Data were collected using a structured questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Descriptive statistics provided counts, frequencies, proportions, and ranges, while inferential statistics established associations between dependent and independent variables. Patient related factors associated with ART defaulting include: Participants age (p-value: 0.046, Cramer's V: 0.2, OR: 0.663, 95% CI: 0.439-0.902), forgetting appointment date (p-value: < 0.001, OR: 4.213, 95% CL: 2.289-7.755), experiencing ART side effects (p-value: < 0.001, OR: 0.438, 95% CL: 0.286-0.672), taking other drugs apart from ART (p-value 0.008, OR: 0.059, 95% CL: 0.007-0.479). ART defaulting was also associated with presence of a psychological disorder among the participants (SRQ statement 7_8) (p-value <0.001, OR: 22.119, 95% CL: 10.81-45.26) and having suicidal ideas (p-value <0.001, OR: 0.111, 95%CL: 0.051-0.241). Seventeen percent (17%) of the youths had psychological disorders, 10% suicidal thoughts, 20.0% anxiety, 12.4% felt worthless, 19.2% troubled mind, 24.8% headache and abdominal discomfort (23.8%). This study sought to identify patient factors associated with ART defaulting in Mzimba district. Participant's age, forgetfulness, ART side effects, taking other drugs and having psychological disorders influence ART defaulting. We recommend that addressing these patient needs, may reduce defaulting to ART.