Family and caregiver support factors associated with self-reported adherence to Antiretroviral Therapy (ART) among HIV+ adolescents in rural Uganda

Globally, over 2.1 million adolescents between 10-19 years are estimated to be living with HIV; approximately 81% (1.7 million) live in sub-Saharan Africa (UNICEF, 2013). Promoting adherence to Antiretroviral Therapy (ART) remains an important element of HIV care and support among adolescents and children living with HIV. Unfortunately, in low resource countries –especially those in sub-Saharan Africa, the majority of children diagnosed with HIV do not begin ART in a timely manner. Family support has been shown to influence adherence to HIV treatment protocols (Lyon et al., 2003; Mellins et al., 2004). However, very few studies investigate ART adherence among adolescents in sub-Saharan Africa. Using cross-sectional data from Southwestern Uganda, we examine family-level factors associated with ART adherence among a sample of 702 adolescents (ages 10-16) living with HIV. Findings indicate that controlling for socioeconomic characteristics, family cohesion (measured by family closeness and availability of timely support) (B= -.02, 95% CI= -.03, -.003, p=.018) is associated with fewer days of missing at least one dose of ART. In addition, adolescents who reported better communication levels (measured by the extent to which caregivers spent time talking to adolescents) were also likely to report: 1) fewer days of missing a dose of ART(B= -.09, 95%CI= -.16, -.02, p=.012), and 2) taking ART in a prescribed manner (B= .12, 95%CI= .06, -.18, p=.000).These findings suggest that family support is still important in promoting adherence to HIV medication, over and above the economic status of caregiving families. Current and future public health programs aimed at increasing adherence to ART, especially in developing countries, should incorporate measures that promote and strengthen family support systems around caring for HIV-positive adolescents.