Abstract
BACKGROUND: Adherence to HIV treatment regimens involves the consistent and correct intake of all prescribed medications. The implementation of antiretroviral therapy (ART) program has significantly reduced mortality among adolescents living with HIV. However, adherence to ART is lower among adolescents compared to other sub-populations and even lower in sub-Saharan Africa. The factors influencing ART adherence are context-specific and vary across countries and regions. In the Tanzanian context, there is a paucity of data regarding these factors. METHODOLOGY: This cross-sectional study involved 385 adolescents and young adults living with HIV receiving treatment at Bombo Hospital Referral Hospital's Care and Treatment Clinic, in Tanga, Tanzania. To assess adherence, a one-month self-recall medication adherence scale was used while a structured questionnaire was used to gather data on determinants of adherence. Data were collected using Google Forms and subsequently exported as a Microsoft Excel file. The data were then entered into Stata software version 15 for cleaning for descriptive and logistic regression analyses. RESULTS: More than a third (35.3%) of adolescents and young adults living with HIV in Tanga were not adherent to the effective and available ART. Adolescents and young adults living in households experiencing moderate food insecurity were 67% less likely to adhere to ART (95%CI 0.16-0.66) compared to those who were food secure. Those with secondary education were 2.3 times more likely to adhere to ART (95%CI 1.02-5.23), compared to those without formal education. While participants who consistently obtain their ART at the clinic were more 4.2 times more likely to adhere to medication (95%CI 1.29-13.72), those experiencing ART side effects were 39% less likely to adhere to ART (95%CI 0.38-0.98). CONCLUSION: More than one-third of adolescents and young adults were not adherent to ART in Tanga, Tanzania. Addressing such unprecedented challenges calls for efforts targeting adolescents and young adults with limited education, from households with food insecurity, and ensuring counseling and management of ART side effects.