PREVALENCE AND FACTORS CONTRIBUTING TO ANTI-RETROVIRAL THERAPY NON-ADHERENCE AMONG YOUTHS ATTENDING HIV CLINIC IN HEALTH FACILITIES OF NYARUGENGE DISTRICT, RWANDA

Abstract

Introduction: HIV continues to pose a major challenge to global public health. As of 2023, an estimated 39 million individuals were living with the virus worldwide, with approximately 26 million residing in Africa. Notably, 49% of the 1.3 million new infections occurred in Africa, with 360,000 among youth aged 15–24. Two in every seven new HIV infections occur in this age group, highlighting their vulnerability. Despite 16,076 HIV-positive youths being enrolled in care and treatment programs by the end of 2023, limited research exists on adherence to anti-retroviral therapy (ART) among this population. Methods: A quantitative cross-sectional study using stratified random sampling was conducted, with 236 participants selected via Fisher’s formula. Data was collected in 12 months from January 2024 till the end of December 2024. Data were analyzed using SPSS version 25. Ethical approval was obtained from Mount Kenya University. Participation was voluntary, with informed consent, confidentiality, and anonymity ensured. Results: The prevalence of ART non-adherence was 42.8%. Significant sociocultural predictors included social support (AOR=0.39, p=0.003) and stigma/discrimination (AOR=0.53, p=0.048). Sociology-economic factors such as daily meal affordability (AOR=0.41, p=0.005) and occupational status were also linked to non-adherence. Biomedical and psychological factors like ART side effects (AOR=0.45, p=0.011), appointment frequency (AOR=0.24, p=0.048), and psychological distress (AOR=0.24, p<0.001) were significant predictors. Conclusion: ART non-adherence among youth is multi-factorial. Addressing this requires targeted interventions such as school-based HIV education, peer-led programs, strengthened social support systems, psychological services, and improved ART appointment management.