Determinants of antiretroviral adherence among HIV positive children and teenagers in rural Tanzania: a mixed methods study
Identifieur interne : 000E18 ( Pmc/Checkpoint ); précédent : 000E17; suivant : 000E19Determinants of antiretroviral adherence among HIV positive children and teenagers in rural Tanzania: a mixed methods study
Auteurs : Daniel Nyogea [Tanzanie, Suisse] ; Sally Mtenga [Tanzanie] ; Lars Henning [Tanzanie, Suisse] ; Fabian C. Franzeck [Tanzanie, Suisse] ; Tracy R. Glass [Suisse] ; Emilio Letang [Tanzanie, Suisse, Espagne] ; Marcel Tanner [Tanzanie, Suisse] ; Eveline Geubbels [Tanzanie]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2015.
Abstract
Around 3.3 million children worldwide are infected with HIV and 90% of them live in sub-Saharan Africa. Our study aimed to estimate adherence levels and find the determinants, facilitators and barriers of ART adherence among children and teenagers in rural Tanzania.
We applied a sequential explanatory mixed method design targeting children and teenagers aged 2–19 years residing in Ifakara. We conducted a quantitative cross sectional study followed by a qualitative study combining focus group discussions (FGDs) and in-depth interviews (IDIs). We used pill count to measure adherence and defined optimal adherence as > =80% of pills being taken. We analysed determinants of poor adherence using logistic regression. We held eight FGDs with adolescent boys and girls on ART and with caretakers. We further explored issues emerging in the FGDs in four in-depth interviews with patients and health workers. Qualitative data was analysed using thematic content analysis.
Out of 116 participants available for quantitative analysis, 70% had optimal adherence levels and the average adherence level was 84%. Living with a non-parent caretaker predicted poor adherence status. From the qualitative component, unfavorable school environment, timing of the morning ART dose, treatment longevity, being unaware of HIV status, non-parental (biological) care, preference for traditional medicine (herbs) and forgetfulness were seen to be barriers for optimal adherence.
The study has highlighted specific challenges in ART adherence faced by children and teenagers. Having a biological parent as a caretaker remains a key determinant of adherence among children and teenagers. To achieve optimal adherence, strategies targeting the caretakers, the school environment, and the health system need to be designed.
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DOI: 10.1186/s12879-015-0753-y
PubMed: 25637106
PubMed Central: 4314748
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<author><name sortKey="Geubbels, Eveline" sort="Geubbels, Eveline" uniqKey="Geubbels E" first="Eveline" last="Geubbels">Eveline Geubbels</name>
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<series><title level="j">BMC Infectious Diseases</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Around 3.3 million children worldwide are infected with HIV and 90% of them live in sub-Saharan Africa. Our study aimed to estimate adherence levels and find the determinants, facilitators and barriers of ART adherence among children and teenagers in rural Tanzania.</p>
</sec>
<sec><title>Methods</title>
<p>We applied a sequential explanatory mixed method design targeting children and teenagers aged 2–19 years residing in Ifakara. We conducted a quantitative cross sectional study followed by a qualitative study combining focus group discussions (FGDs) and in-depth interviews (IDIs). We used pill count to measure adherence and defined optimal adherence as > =80% of pills being taken. We analysed determinants of poor adherence using logistic regression. We held eight FGDs with adolescent boys and girls on ART and with caretakers. We further explored issues emerging in the FGDs in four in-depth interviews with patients and health workers. Qualitative data was analysed using thematic content analysis.</p>
</sec>
<sec><title>Results</title>
<p>Out of 116 participants available for quantitative analysis, 70% had optimal adherence levels and the average adherence level was 84%. Living with a non-parent caretaker predicted poor adherence status. From the qualitative component, unfavorable school environment, timing of the morning ART dose, treatment longevity, being unaware of HIV status, non-parental (biological) care, preference for traditional medicine (herbs) and forgetfulness were seen to be barriers for optimal adherence.</p>
</sec>
<sec><title>Conclusion</title>
<p>The study has highlighted specific challenges in ART adherence faced by children and teenagers. Having a biological parent as a caretaker remains a key determinant of adherence among children and teenagers. To achieve optimal adherence, strategies targeting the caretakers, the school environment, and the health system need to be designed.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Paintsil, E" uniqKey="Paintsil E">E Paintsil</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Paterson, Dl" uniqKey="Paterson D">DL Paterson</name>
</author>
<author><name sortKey="Swindells, S" uniqKey="Swindells S">S Swindells</name>
</author>
<author><name sortKey="Mohr, J" uniqKey="Mohr J">J Mohr</name>
</author>
<author><name sortKey="Brester, M" uniqKey="Brester M">M Brester</name>
</author>
<author><name sortKey="Vergis, En" uniqKey="Vergis E">EN Vergis</name>
</author>
<author><name sortKey="Squier, C" uniqKey="Squier C">C Squier</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Harries, Ad" uniqKey="Harries A">AD Harries</name>
</author>
<author><name sortKey="Gomani, P" uniqKey="Gomani P">P Gomani</name>
</author>
<author><name sortKey="Teck, R" uniqKey="Teck R">R Teck</name>
</author>
<author><name sortKey="De Teck, Oa" uniqKey="De Teck O">OA de Teck</name>
</author>
<author><name sortKey="Bakali, E" uniqKey="Bakali E">E Bakali</name>
</author>
<author><name sortKey="Zachariah, R" uniqKey="Zachariah R">R Zachariah</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Nachega, Jb" uniqKey="Nachega J">JB Nachega</name>
</author>
<author><name sortKey="Mills, Ej" uniqKey="Mills E">EJ Mills</name>
</author>
<author><name sortKey="Schechter, M" uniqKey="Schechter M">M Schechter</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bangsberg, Dr" uniqKey="Bangsberg D">DR Bangsberg</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Steele, Rg" uniqKey="Steele R">RG Steele</name>
</author>
<author><name sortKey="Nelson, Td" uniqKey="Nelson T">TD Nelson</name>
</author>
<author><name sortKey="Cole, Bp" uniqKey="Cole B">BP Cole</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Stoeckle, M" uniqKey="Stoeckle M">M Stoeckle</name>
</author>
<author><name sortKey="Mchomvu, R" uniqKey="Mchomvu R">R McHomvu</name>
</author>
<author><name sortKey="Hatz, C" uniqKey="Hatz C">C Hatz</name>
</author>
<author><name sortKey="Battegay, M" uniqKey="Battegay M">M Battegay</name>
</author>
<author><name sortKey="Aris, Ea" uniqKey="Aris E">EA Aris</name>
</author>
<author><name sortKey="Mshinda, H" uniqKey="Mshinda H">H Mshinda</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mossdorf, E" uniqKey="Mossdorf E">E Mossdorf</name>
</author>
<author><name sortKey="Stoeckle, M" uniqKey="Stoeckle M">M Stoeckle</name>
</author>
<author><name sortKey="Mwaigomole, Eg" uniqKey="Mwaigomole E">EG Mwaigomole</name>
</author>
<author><name sortKey="Chiweka, E" uniqKey="Chiweka E">E Chiweka</name>
</author>
<author><name sortKey="Kibatala, Pl" uniqKey="Kibatala P">PL Kibatala</name>
</author>
<author><name sortKey="Geubbels, E" uniqKey="Geubbels E">E Geubbels</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mossdorf, E" uniqKey="Mossdorf E">E Mossdorf</name>
</author>
<author><name sortKey="Stoeckle, M" uniqKey="Stoeckle M">M Stoeckle</name>
</author>
<author><name sortKey="Vincenz, A" uniqKey="Vincenz A">A Vincenz</name>
</author>
<author><name sortKey="Mwaigomole, Eg" uniqKey="Mwaigomole E">EG Mwaigomole</name>
</author>
<author><name sortKey="Chiweka, E" uniqKey="Chiweka E">E Chiweka</name>
</author>
<author><name sortKey="Kibatala, P" uniqKey="Kibatala P">P Kibatala</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Nikoi, Ca" uniqKey="Nikoi C">CA Nikoi</name>
</author>
<author><name sortKey="Odimegwu, C" uniqKey="Odimegwu C">C Odimegwu</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Merton, Rk" uniqKey="Merton R">RK Merton</name>
</author>
<author><name sortKey="Fiske, M" uniqKey="Fiske M">M Fiske</name>
</author>
<author><name sortKey="Kendall, Pl" uniqKey="Kendall P">PL Kendall</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Krueger, Ra" uniqKey="Krueger R">RA Krueger</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Babbie, Er" uniqKey="Babbie E">ER Babbie</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Li, Rj" uniqKey="Li R">RJ Li</name>
</author>
<author><name sortKey="Jaspan, Hb" uniqKey="Jaspan H">HB Jaspan</name>
</author>
<author><name sortKey="O Rien, V" uniqKey="O Rien V">V O’Brien</name>
</author>
<author><name sortKey="Rabie, H" uniqKey="Rabie H">H Rabie</name>
</author>
<author><name sortKey="Cotton, Mf" uniqKey="Cotton M">MF Cotton</name>
</author>
<author><name sortKey="Nattrass, N" uniqKey="Nattrass N">N Nattrass</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ajzen, I" uniqKey="Ajzen I">I Ajzen</name>
</author>
<author><name sortKey="Fishbein, M" uniqKey="Fishbein M">M Fishbein</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rosenstock, Im" uniqKey="Rosenstock I">IM Rosenstock</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Anderson, R" uniqKey="Anderson R">R Anderson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lecompte, Md" uniqKey="Lecompte M">MD LeCompte</name>
</author>
<author><name sortKey="Preissle Goetz, J" uniqKey="Preissle Goetz J">J Preissle-Goetz</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Vreeman, Rc" uniqKey="Vreeman R">RC Vreeman</name>
</author>
<author><name sortKey="Wiehe, Se" uniqKey="Wiehe S">SE Wiehe</name>
</author>
<author><name sortKey="Pearce, Ec" uniqKey="Pearce E">EC Pearce</name>
</author>
<author><name sortKey="Nyandiko, Wm" uniqKey="Nyandiko W">WM Nyandiko</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Seth, A" uniqKey="Seth A">A Seth</name>
</author>
<author><name sortKey="Gupta, R" uniqKey="Gupta R">R Gupta</name>
</author>
<author><name sortKey="Chandra, J" uniqKey="Chandra J">J Chandra</name>
</author>
<author><name sortKey="Maheshwari, A" uniqKey="Maheshwari A">A Maheshwari</name>
</author>
<author><name sortKey="Kumar, P" uniqKey="Kumar P">P Kumar</name>
</author>
<author><name sortKey="Aneja, S" uniqKey="Aneja S">S Aneja</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mghamba, Fw" uniqKey="Mghamba F">FW Mghamba</name>
</author>
<author><name sortKey="Minzi, Om" uniqKey="Minzi O">OM Minzi</name>
</author>
<author><name sortKey="Massawe, A" uniqKey="Massawe A">A Massawe</name>
</author>
<author><name sortKey="Sasi, P" uniqKey="Sasi P">P Sasi</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Biressaw, S" uniqKey="Biressaw S">S Biressaw</name>
</author>
<author><name sortKey="Abegaz, We" uniqKey="Abegaz W">WE Abegaz</name>
</author>
<author><name sortKey="Abebe, M" uniqKey="Abebe M">M Abebe</name>
</author>
<author><name sortKey="Taye, Wa" uniqKey="Taye W">WA Taye</name>
</author>
<author><name sortKey="Belay, M" uniqKey="Belay M">M Belay</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Martin, S" uniqKey="Martin S">S Martin</name>
</author>
<author><name sortKey="Elliott Desorbo, Dk" uniqKey="Elliott Desorbo D">DK Elliott-DeSorbo</name>
</author>
<author><name sortKey="Calabrese, S" uniqKey="Calabrese S">S Calabrese</name>
</author>
<author><name sortKey="Wolters, Pl" uniqKey="Wolters P">PL Wolters</name>
</author>
<author><name sortKey="Roby, G" uniqKey="Roby G">G Roby</name>
</author>
<author><name sortKey="Brennan, T" uniqKey="Brennan T">T Brennan</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Marcus, En" uniqKey="Marcus E">EN Marcus</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Nabukeera Barungi, N" uniqKey="Nabukeera Barungi N">N Nabukeera-Barungi</name>
</author>
<author><name sortKey="Kalyesubula, I" uniqKey="Kalyesubula I">I Kalyesubula</name>
</author>
<author><name sortKey="Kekitiinwa, A" uniqKey="Kekitiinwa A">A Kekitiinwa</name>
</author>
<author><name sortKey="Byakika Tusiime, J" uniqKey="Byakika Tusiime J">J Byakika-Tusiime</name>
</author>
<author><name sortKey="Musoke, P" uniqKey="Musoke P">P Musoke</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bachanas, Pj" uniqKey="Bachanas P">PJ Bachanas</name>
</author>
<author><name sortKey="Kullgren, Ka" uniqKey="Kullgren K">KA Kullgren</name>
</author>
<author><name sortKey="Schwartz, Ks" uniqKey="Schwartz K">KS Schwartz</name>
</author>
<author><name sortKey="Lanier, B" uniqKey="Lanier B">B Lanier</name>
</author>
<author><name sortKey="Mcdaniel, Js" uniqKey="Mcdaniel J">JS McDaniel</name>
</author>
<author><name sortKey="Smith, J" uniqKey="Smith J">J Smith</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bikaako Kajura, W" uniqKey="Bikaako Kajura W">W Bikaako-Kajura</name>
</author>
<author><name sortKey="Luyirika, E" uniqKey="Luyirika E">E Luyirika</name>
</author>
<author><name sortKey="Purcell, Dw" uniqKey="Purcell D">DW Purcell</name>
</author>
<author><name sortKey="Downing, J" uniqKey="Downing J">J Downing</name>
</author>
<author><name sortKey="Kaharuza, F" uniqKey="Kaharuza F">F Kaharuza</name>
</author>
<author><name sortKey="Mermin, J" uniqKey="Mermin J">J Mermin</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Blasini, I" uniqKey="Blasini I">I Blasini</name>
</author>
<author><name sortKey="Chantry, C" uniqKey="Chantry C">C Chantry</name>
</author>
<author><name sortKey="Cruz, C" uniqKey="Cruz C">C Cruz</name>
</author>
<author><name sortKey="Ortiz, L" uniqKey="Ortiz L">L Ortiz</name>
</author>
<author><name sortKey="Salabarria, I" uniqKey="Salabarria I">I Salabarria</name>
</author>
<author><name sortKey="Scalley, N" uniqKey="Scalley N">N Scalley</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lesch, A" uniqKey="Lesch A">A Lesch</name>
</author>
<author><name sortKey="Swartz, L" uniqKey="Swartz L">L Swartz</name>
</author>
<author><name sortKey="Kagee, A" uniqKey="Kagee A">A Kagee</name>
</author>
<author><name sortKey="Moodley, K" uniqKey="Moodley K">K Moodley</name>
</author>
<author><name sortKey="Kafaar, Z" uniqKey="Kafaar Z">Z Kafaar</name>
</author>
<author><name sortKey="Myer, L" uniqKey="Myer L">L Myer</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Weiser, Sd" uniqKey="Weiser S">SD Weiser</name>
</author>
<author><name sortKey="Tuller, Dm" uniqKey="Tuller D">DM Tuller</name>
</author>
<author><name sortKey="Frongillo, Ea" uniqKey="Frongillo E">EA Frongillo</name>
</author>
<author><name sortKey="Senkungu, J" uniqKey="Senkungu J">J Senkungu</name>
</author>
<author><name sortKey="Mukiibi, N" uniqKey="Mukiibi N">N Mukiibi</name>
</author>
<author><name sortKey="Bangsberg, Dr" uniqKey="Bangsberg D">DR Bangsberg</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Chinsembu, Kc" uniqKey="Chinsembu K">KC Chinsembu</name>
</author>
<author><name sortKey="Shimwooshili Shaimemanya, Cn" uniqKey="Shimwooshili Shaimemanya C">CN Shimwooshili-Shaimemanya</name>
</author>
<author><name sortKey="Kasanda, Cd" uniqKey="Kasanda C">CD Kasanda</name>
</author>
<author><name sortKey="Zealand, D" uniqKey="Zealand D">D Zealand</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Halkitis, Pn" uniqKey="Halkitis P">PN Halkitis</name>
</author>
<author><name sortKey="Shrem, Mt" uniqKey="Shrem M">MT Shrem</name>
</author>
<author><name sortKey="Zade, Dd" uniqKey="Zade D">DD Zade</name>
</author>
<author><name sortKey="Wilton, L" uniqKey="Wilton L">L Wilton</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Carr, Rl" uniqKey="Carr R">RL Carr</name>
</author>
<author><name sortKey="Gramling, Lf" uniqKey="Gramling L">LF Gramling</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ickovics, Jr" uniqKey="Ickovics J">JR Ickovics</name>
</author>
<author><name sortKey="Meade, Cs" uniqKey="Meade C">CS Meade</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Fong, Ow" uniqKey="Fong O">OW Fong</name>
</author>
<author><name sortKey="Ho, Cf" uniqKey="Ho C">CF Ho</name>
</author>
<author><name sortKey="Fung, Ly" uniqKey="Fung L">LY Fung</name>
</author>
<author><name sortKey="Lee, Fk" uniqKey="Lee F">FK Lee</name>
</author>
<author><name sortKey="Tse, Wh" uniqKey="Tse W">WH Tse</name>
</author>
<author><name sortKey="Yuen, Cy" uniqKey="Yuen C">CY Yuen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Goldman, Dp" uniqKey="Goldman D">DP Goldman</name>
</author>
<author><name sortKey="Smith, Jp" uniqKey="Smith J">JP Smith</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Adler, Ne" uniqKey="Adler N">NE Adler</name>
</author>
<author><name sortKey="Newman, K" uniqKey="Newman K">K Newman</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Falagas, Me" uniqKey="Falagas M">ME Falagas</name>
</author>
<author><name sortKey="Zarkadoulia, Ea" uniqKey="Zarkadoulia E">EA Zarkadoulia</name>
</author>
<author><name sortKey="Pliatsika, Pa" uniqKey="Pliatsika P">PA Pliatsika</name>
</author>
<author><name sortKey="Panos, G" uniqKey="Panos G">G Panos</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Liu, H" uniqKey="Liu H">H Liu</name>
</author>
<author><name sortKey="Golin, Ce" uniqKey="Golin C">CE Golin</name>
</author>
<author><name sortKey="Miller, Lg" uniqKey="Miller L">LG Miller</name>
</author>
<author><name sortKey="Hays, Rd" uniqKey="Hays R">RD Hays</name>
</author>
<author><name sortKey="Beck, Ck" uniqKey="Beck C">CK Beck</name>
</author>
<author><name sortKey="Sanandaji, S" uniqKey="Sanandaji S">S Sanandaji</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Feinstein, Ar" uniqKey="Feinstein A">AR Feinstein</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ajose, O" uniqKey="Ajose O">O Ajose</name>
</author>
<author><name sortKey="Mookerjee, S" uniqKey="Mookerjee S">S Mookerjee</name>
</author>
<author><name sortKey="Mills, Ej" uniqKey="Mills E">EJ Mills</name>
</author>
<author><name sortKey="Boulle, A" uniqKey="Boulle A">A Boulle</name>
</author>
<author><name sortKey="Ford, N" uniqKey="Ford N">N Ford</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cohen, Ms" uniqKey="Cohen M">MS Cohen</name>
</author>
<author><name sortKey="Chen, Yq" uniqKey="Chen Y">YQ Chen</name>
</author>
<author><name sortKey="Mccauley, M" uniqKey="Mccauley M">M McCauley</name>
</author>
<author><name sortKey="Gamble, T" uniqKey="Gamble T">T Gamble</name>
</author>
<author><name sortKey="Hosseinipour, Mc" uniqKey="Hosseinipour M">MC Hosseinipour</name>
</author>
<author><name sortKey="Kumarasamy, N" uniqKey="Kumarasamy N">N Kumarasamy</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Infect. Dis</journal-id>
<journal-title-group><journal-title>BMC Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2334</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25637106</article-id>
<article-id pub-id-type="pmc">4314748</article-id>
<article-id pub-id-type="publisher-id">753</article-id>
<article-id pub-id-type="doi">10.1186/s12879-015-0753-y</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Determinants of antiretroviral adherence among HIV positive children and teenagers in rural Tanzania: a mixed methods study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Nyogea</surname>
<given-names>Daniel</given-names>
</name>
<address><email>dnyogea@ihi.or.tz</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mtenga</surname>
<given-names>Sally</given-names>
</name>
<address><email>smtenga@ihi.or.tz</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Henning</surname>
<given-names>Lars</given-names>
</name>
<address><email>lhenning@idi.co.ug</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Franzeck</surname>
<given-names>Fabian C</given-names>
</name>
<address><email>fabian@ggaweb.ch</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Glass</surname>
<given-names>Tracy R</given-names>
</name>
<address><email>Tracy.Glass@unibas.ch</email>
</address>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Letang</surname>
<given-names>Emilio</given-names>
</name>
<address><email>emili.letang@unibas.ch</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tanner</surname>
<given-names>Marcel</given-names>
</name>
<address><email>Marcel.Tanner@unibas.ch</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Geubbels</surname>
<given-names>Eveline</given-names>
</name>
<address><email>egeubbels@ihi.or.tz</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<aff id="Aff1"><label></label>
Ifakara Health institute, P.O Box 153, Ifakara, Tanzania</aff>
<aff id="Aff2"><label></label>
Swiss Tropical and Public Health Institute, Basel, Switzerland</aff>
<aff id="Aff3"><label></label>
ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain</aff>
<aff id="Aff4"><label></label>
University Hospital of Zurich, Zürich, Switzerland</aff>
</contrib-group>
<pub-date pub-type="epub"><day>31</day>
<month>1</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>31</day>
<month>1</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>15</volume>
<elocation-id>28</elocation-id>
<history><date date-type="received"><day>6</day>
<month>9</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>13</day>
<month>1</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© Nyogea et al.; licensee BioMed Central. 2015</copyright-statement>
<license license-type="open-access"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>Around 3.3 million children worldwide are infected with HIV and 90% of them live in sub-Saharan Africa. Our study aimed to estimate adherence levels and find the determinants, facilitators and barriers of ART adherence among children and teenagers in rural Tanzania.</p>
</sec>
<sec><title>Methods</title>
<p>We applied a sequential explanatory mixed method design targeting children and teenagers aged 2–19 years residing in Ifakara. We conducted a quantitative cross sectional study followed by a qualitative study combining focus group discussions (FGDs) and in-depth interviews (IDIs). We used pill count to measure adherence and defined optimal adherence as > =80% of pills being taken. We analysed determinants of poor adherence using logistic regression. We held eight FGDs with adolescent boys and girls on ART and with caretakers. We further explored issues emerging in the FGDs in four in-depth interviews with patients and health workers. Qualitative data was analysed using thematic content analysis.</p>
</sec>
<sec><title>Results</title>
<p>Out of 116 participants available for quantitative analysis, 70% had optimal adherence levels and the average adherence level was 84%. Living with a non-parent caretaker predicted poor adherence status. From the qualitative component, unfavorable school environment, timing of the morning ART dose, treatment longevity, being unaware of HIV status, non-parental (biological) care, preference for traditional medicine (herbs) and forgetfulness were seen to be barriers for optimal adherence.</p>
</sec>
<sec><title>Conclusion</title>
<p>The study has highlighted specific challenges in ART adherence faced by children and teenagers. Having a biological parent as a caretaker remains a key determinant of adherence among children and teenagers. To achieve optimal adherence, strategies targeting the caretakers, the school environment, and the health system need to be designed.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>ART adherence</kwd>
<kwd>Children</kwd>
<kwd>Teenagers</kwd>
<kwd>Pill count</kwd>
<kwd>Non-parental caretaker</kwd>
<kwd>Focus group discussions</kwd>
<kwd>In-depth interviews</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2015</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Espagne</li>
<li>Suisse</li>
<li>Tanzanie</li>
</country>
<region><li>Canton de Zurich</li>
<li>Catalogne</li>
</region>
<settlement><li>Barcelone</li>
<li>Zurich</li>
</settlement>
<orgName><li>Université de Barcelone</li>
</orgName>
</list>
<tree><country name="Tanzanie"><noRegion><name sortKey="Nyogea, Daniel" sort="Nyogea, Daniel" uniqKey="Nyogea D" first="Daniel" last="Nyogea">Daniel Nyogea</name>
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<name sortKey="Franzeck, Fabian C" sort="Franzeck, Fabian C" uniqKey="Franzeck F" first="Fabian C" last="Franzeck">Fabian C. Franzeck</name>
<name sortKey="Geubbels, Eveline" sort="Geubbels, Eveline" uniqKey="Geubbels E" first="Eveline" last="Geubbels">Eveline Geubbels</name>
<name sortKey="Henning, Lars" sort="Henning, Lars" uniqKey="Henning L" first="Lars" last="Henning">Lars Henning</name>
<name sortKey="Letang, Emilio" sort="Letang, Emilio" uniqKey="Letang E" first="Emilio" last="Letang">Emilio Letang</name>
<name sortKey="Mtenga, Sally" sort="Mtenga, Sally" uniqKey="Mtenga S" first="Sally" last="Mtenga">Sally Mtenga</name>
<name sortKey="Tanner, Marcel" sort="Tanner, Marcel" uniqKey="Tanner M" first="Marcel" last="Tanner">Marcel Tanner</name>
</country>
<country name="Suisse"><noRegion><name sortKey="Nyogea, Daniel" sort="Nyogea, Daniel" uniqKey="Nyogea D" first="Daniel" last="Nyogea">Daniel Nyogea</name>
</noRegion>
<name sortKey="Franzeck, Fabian C" sort="Franzeck, Fabian C" uniqKey="Franzeck F" first="Fabian C" last="Franzeck">Fabian C. Franzeck</name>
<name sortKey="Glass, Tracy R" sort="Glass, Tracy R" uniqKey="Glass T" first="Tracy R" last="Glass">Tracy R. Glass</name>
<name sortKey="Henning, Lars" sort="Henning, Lars" uniqKey="Henning L" first="Lars" last="Henning">Lars Henning</name>
<name sortKey="Henning, Lars" sort="Henning, Lars" uniqKey="Henning L" first="Lars" last="Henning">Lars Henning</name>
<name sortKey="Letang, Emilio" sort="Letang, Emilio" uniqKey="Letang E" first="Emilio" last="Letang">Emilio Letang</name>
<name sortKey="Tanner, Marcel" sort="Tanner, Marcel" uniqKey="Tanner M" first="Marcel" last="Tanner">Marcel Tanner</name>
</country>
<country name="Espagne"><region name="Catalogne"><name sortKey="Letang, Emilio" sort="Letang, Emilio" uniqKey="Letang E" first="Emilio" last="Letang">Emilio Letang</name>
</region>
</country>
</tree>
</affiliations>
</record>
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