A Qualitative Assessment of the Determinants of Adherence to Antiretroviral Therapy among Adolescents living with HIV in the Centre Region of Cameroon

A. Ketchaji, H. Ngouakam, F. Assah, Alexandre Ndjalla, F. Monebenimp, N. Marcelin
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Abstract

Background: Adherence to antiretroviral therapy (ART) is known to be challenging among adolescents living with HIV/AIDS, meanwhile it is the key to success for ART programmes. In Cameroon, although a few researchers have investigated on the quantitative aspects of adherence among adolescents, less is known about qualitative information. This study aimed at investigating the key factors that contribute to ART adherence for adolescents living with HIV in the Centre Region of Cameroon.   Methods: The study was conducted in the Centre Region of Cameroon. Adolescents on ART with disclosed status was recruited from health facilities. Six focus group discussion (FGD) sessions were conducted with 56 adolescents both girls and boys aged more than 15. In addition, 3 FGD with 34 parents/guardians and 10 individual in-depth interviews with health care providers were all conducted between the months of June and September 2018.   Results: A total of 56 adolescents, 34 parents and 10 health care providers were approached for participation. Results showed that a range of factors related to the individual, family, environment, medication and health system levels determine the reasons for poor adherence to ART among adolescents living with HIV. In fact, most adolescents mentioned in this study that compliance with medicine intake is seen as a punishment or drudgery.     Conclusion: In supporting adherence to ART, it would be important to develop approaches that facilitate and help adolescents to adequately comply to medication intake like the creation of discussion groups through phone messages and WhatsApp for the sharing of experiences and for mutual support. A multi-sectorial approach would also be needed to address this issue.
喀麦隆中部地区青少年艾滋病毒感染者坚持抗逆转录病毒治疗决定因素的定性评估
背景:众所周知,在感染艾滋病毒/艾滋病的青少年中,坚持抗逆转录病毒治疗(ART)是一项挑战,同时这也是抗逆转录病毒治疗规划成功的关键。在喀麦隆,虽然一些研究人员调查了青少年依从性的定量方面,但对定性信息知之甚少。本研究旨在调查喀麦隆中部地区感染艾滋病毒的青少年坚持抗逆转录病毒治疗的关键因素。方法:本研究在喀麦隆中部地区进行。从卫生机构招募接受抗逆转录病毒治疗且状况公开的青少年。对56名15岁以上的男女青少年进行了六次焦点小组讨论。此外,在2018年6月至9月期间,对34名家长/监护人进行了3次FGD,并对医疗服务提供者进行了10次个人深度访谈。结果:共接触了56名青少年、34名家长和10名卫生保健提供者。结果表明,与个人、家庭、环境、药物和卫生系统水平相关的一系列因素决定了感染艾滋病毒的青少年抗逆转录病毒治疗依从性差的原因。事实上,在这项研究中提到的大多数青少年,遵守药物摄入被视为一种惩罚或苦役。结论:在支持坚持抗逆转录病毒治疗方面,重要的是制定促进和帮助青少年充分遵守药物摄入的方法,如通过电话短信和WhatsApp创建讨论组,分享经验和相互支持。还需要采取多部门的办法来解决这个问题。
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