Level of Adherence and Risky Behaviours Among HIV-Positive Young People Aged 18-24 on Retroviral Therapy in Epworth, Seke District, 2022

Abstract

Young people living with HIV are a heterogeneous group with multiple, interlinked factors affecting antiretroviral therapy (ART) adherence. Young people face a myriad of differential factors affecting adherence such as limited knowledge, substance abuse, risky sexual behaviour and poor satisfaction with health service delivery. The purpose of this study was to determine level of antiretroviral therapy adherence and associated risky behaviours among young people aged 18-24 in Epworth, Seke District in 2022. An analytical cross-sectional study was done to assess level of antiretroviral therapy adherence and associated behavioural factors among young people living with HIV. Young people aged 18-24 enrolled on antiretroviral therapy at the Epworth clinics and residing in the district, enrolled on antiretroviral treatment for at least six months prior to the start of the research, willing to participate and capable to provide consent were included in the study. Proportionate stratified random sampling was adopted using a sampling fraction of 0.18 and sample size of 250 was calculated using Cochran’s formula. Data was collected using an interviewer administered questionnaire. Analysis was done using SPSS for bi-variate, multi-variate logistic regression analyses to identify independent predictors of antiretroviral therapy adherence. The study found an ART adherence rate of 76.0%, prevalence of risky sexual behaviour of 64.3% and drug-use prevalence of 13.2%. A multivariate analysis showed perceiving that skipping ART medication from time to time will not affect a person at all [AOR=0.4; 95% CI (0.1– 0.9); p=0.047]; perceiving that ART does more harm than good [AOR=0.3; 95% CI (0.1– 0.7); p=0.005]; early sexual debut [AOR=0.1; 95% CI (0.0–0.4); p=0.006]; not using condoms because partner is HIV positive [AOR=0.0; 95% CI (0.0– 0.3); p=0.014] and waiting time to collect ART [AOR=3.3; 95% CI (1.3–8.5); p=0.014] were statistically significant predictors of ART adherence. There is need to address social factors contributing to low ART adherence through strengthening community support and integrated service delivery that also addresses sexual and reproductive health needs of young people.