Modelling adherence to antiretroviral therapy(ART) among Adolescents (15-24 years) in Uganda: A Case of Mildmay – Kampala, Uganda

Abstract

The study intended to model adherence to Antiretroviral Therapy (ART) among adolescents (15-24 years) in Uganda. The study objectives included: investigating how adherence information score, adherence motivation score, and adherence behavioural skills score, controlled by age, sex, education level and marital status predicts adolescent adherence to ART. It further established possible interactions between the IMB constructs and the sociodemographic characteristics. This was a longitudinal study conducted using a secondary dataset from Mildmay Uganda. Descriptive statistics were used at the univariate level, Pearson Chi-square test for associations between the dependent and each independent variable was applied. Logistic regression was performed at three 6-month time periods and for overall adherence (over month1-18) to find predictors of short term and long-term adherence. To model overall adherence, a random effects logistic model was applied. The key predictors of adherence investigated in the study included constructs of the information, Motivation and behavioural skills (IMB) model, in which only motivation was statistically significant. Highly motivated individuals had about fourfold the odds of adhering to ART as compared to individuals with low motivation scores (Odds ratio = 3.77, P-value = 0.00) to predict optimal adherence after controlling for socio-demographic variables; sex, education attainment and marital status. Many of these variables were static, and could not measure the dynamic aspects of the intervention. In conclusion, while caring for or handling adolescents living with HIV/AIDS, it is important to engage them in activities that arouse their motivation towards adherence to antiretroviral therapy (ART). It was established that high levels of motivation to adherence were significantly associated with near perfect adherence among adolescents. Finally, the study recommended that interventions aimed at enhancing adherence among adolescents and young adults, should put much emphasis on building their personal and social motivation.