title: Adherence to highly active antiretroviral therapy and its correlates among HIV infected pediatric patients in Ethiopia.
abstract: BACKGROUND
  The introduction of combination antiretroviral therapy (ART) has resulted in striking reductions in HIV-related mortality. Despite increased availability of ART, children remain a neglected population. This may be due to concerns that failure to adhere appears to be related to continued viral replication, treatment failure and the emergence of drug-resistant strains of HIV. This study determines the rates and factors associated with adherence to Antiretroviral (ARV) Drug therapy in HIV-infected children who were receiving Highly Active Antiretroviral Therapy (HAART) in Addis Ababa, Ethiopia in 2008.
  
  
  METHODS
  A cross-sectional study was conducted in five hospitals in Addis Ababa from February 18 - April 28, 2008. The study population entailed parents/caretaker and index children who were following ART in the health facilities. A structured questionnaire was used for data collection.
  
  
  RESULTS
  A total of 390 children respondents were included in the study with a response rate of 91%. The majority, equaling 205 (52.6%) of the children, were greater than 9 years of age. Fifty five percent of the children were girls. A total of 339 children (86.9%) as reported by caregivers were adherent to antiretroviral drugs for the past 7 days before the interview. Numerous variables were found to be significantly associated with adherence: children whose parents did not pay a fee for treatment [OR = 0.39 (95%CI: 0.16, 0.92)], children who had ever received any nutritional support from the clinic [OR = 0.34 (95%CI: 0.14, 0.79)] were less likely to adhere. Whereas children who took co-trimoxazole medication/syrup besides ARVs [OR = 3.65 (95%CI: 1.24, 10.74)], children who did not know their sero-status [OR = 2.53 (95%CI: 1.24, 5.19)] and children who were not aware of their caregiver's health problem [OR = 2.45 (95%CI: 1.25, 4.81)] were more likely to adhere than their counterparts.
  
  
  CONCLUSIONS
  Adherence to HAART in children in Addis Ababa was higher than other similar set-ups. However, there are still significant numbers of children who are non-adherent to HAART.
authors.affiliation: Fayyaa Integrated Development Association-NCMI, PEPFAR-New Partners Initiative, Addis Ababa, Ethiopia. sibhatu2005@yahoo.com
authors.forename: Sibhatu
authors.initials: S
authors.lastname: Biadgilign
authors.forename: Amare
authors.initials: A
authors.lastname: Deribew
authors.forename: Alemayehu
authors.initials: A
authors.lastname: Amberbir
authors.forename: Kebede
authors.initials: K
authors.lastname: Deribe
mesh_terms: D000293:Adolescent; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D006678:HIV / Q000187:drug effects*; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D019538:Health Care Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires / Q000592:standards; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000523:psychology / Q000706:statistics & numerical data