Psychosocial challenges and adherence to antiretroviral therapy among HIV-positive adolescents attending an ART center in Kano, northwestern Nigeria -

Background: HIV-infected adolescents confront numerous psychosocial stressors in addition to coping with the developmental challenges of normal adolescent children. These may adversely affect their adherence to antiretroviral treatment. Objective: To determine the psychosocial challenges of HIV-positive adolescents in Kano, Nigeria, and how they influence their adherence to antiretroviral therapy (ART). Materials and Methods: Using descriptive cross-sectional design, we studied a random sample of 400 HIV-positive adolescents attending the ART center in Murtala Muhammad Specialist Hospital Data were analyzed using SPSS, version 16.0, computer statistical software. Result: The mean age of the adolescents was 14.9 ± 3.15 years; majority of them were female subjects (54.8%) and from polygamous family setting (57.5%). More than half (54.5%) of them reported being anxious or depressed most of the times, commonly from fear of death (51.4%) or associated stigma (24.3%). Furthermore, 52.0% of them had lost a parent or spouse to HIV infection and about one-tenth reported being discriminated upon. More than one-third (38.5%) of them were out of school, of which 56.5% of them dropped out because the parents/guardians could not afford the combined burden of hospital costs and school. Most of them (90.5%) adhered well to prescribed medications. On multivariate analysis, anxiety or depression, loss of parent or spouse, and avoidance by friends/colleagues emerged as the independent psychosocial predictors of the adolescents’ adherence to ART. Conclusion: HIV-infected adolescents have varied and sensitive needs that must attract high-level understanding of program managers and the social environment to achieve an optimum level of adherence for ART.