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Abstract; Background: Adherence to Anti-Retroviral Therapy (ART) is required to achieve HIV viral load suppression but children under five years in Jinja, Uganda, had been shown to have low HIV suppression rates. This study aimed to determine the level of ART non-adherence among these children and the associated factors. Methods: Data for the cross-sectional study was obtained from caregivers of 206 HIV positive children under five years attending health facilities in Jinja who had been on ART for at least three months. Non-adherence was measured using a Visual Analog Scale that assessed both dosing and timing non-adherence, and by determining the Proportion of Days Covered by the medication. A questionnaire administered to the caregivers was used to collect the data, together with medical record review. A child was only considered adherent if they had adherence greater than 95% on both measures. The data was analysed using Modified Poisson Regression, taking a p-value less than 0.05 as statistically significant. Results: Of the 206 children, 73.8% were older than 2 years, and 52.9% were female. Likewise, the majority of the caregivers were female (93.7%). According to the combined adherence measure, 51.5% of the children were categorized as non-adherent. School attendance, Prevalence Ratio (PR) = 1.32 (p = 0.024), receiving financial support from family, PR = 0.68 (p = 0.026) and satisfaction with the quality of service at the health facility, PR = 0.96 (p <0.001) were associated with non-adherence. Household food insecurity was also associated with non-adherence: PR = 1.63 (p = 0.007) for mild food insecurity, PR= 1.67 (p = 0.006) for moderate insecurity and PR = 1.59 (p = 0.006) for severe food insecurity. Conclusions: Children under five years in Jinja had a high level of ART non-adherence. It is important to engage schools to support adherence among children living with HIV. Addressing household food insecurity would also reduce the barriers to optimal adherence. |
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