Insights into Adherence among a Cohort of Adolescents Aged 12–20 Years in South Africa: Reported Barriers to Antiretroviral Treatment

Table 3

Factors associated with having at least one late or missed visit .

Characteristic	(%) with missed visit	Crude risk ratio (95% CI)	Adjusted risk ratio (95% CI)
Baseline and demographic factors
Gender
Female	27 (39.1)	1.00	1.00
Male	20 (36.4)	0.93 (0.59–1.47)	1.27 (0.76–2.12)
Age group
12–14 years	15 (28.3)	1.00	1.00
15–17 years	14 (41.2)	1.45 (0.81–2.62)	1.80 (0.94–3.43)
18–20 years	18 (48.6)	1.72 (1.00–2.95)	2.62 (0.89–7.67)
Highest school level
Secondary	21 (44.7)	1.00	1.00
Primary	22 (32.8)	0.73 (0.46–1.17)	1.37 (0.69–2.72)
Dwelling type
Formal	36 (38.3)	1.00	1.00
Care facility	5 (38.5)	1.00 (0.48–2.09)	0.82 (0.40–1.70)
Informal	6 (35.3)	0.92 (0.46–1.84)	1.41 (0.65–3.09)
Mother as caregiver
No	27 (45.8)	1.00	1.00
Yes	20 (30.8)	0.67 (0.43–1.06)	0.66 (0.43–1.03)
Caregiver employed
No	10 (30.3)	1.00	1.00
Yes	32 (40.5)	1.34 (0.75–2.39)	1.40 (0.79–2.48)
Time on ART
<6 years	24 (40.0)	1.00	1.00
>6 years	23 (35.9)	0.90 (0.57–1.41)	0.98 (0.42–2.29)
Caregiver-related factors
Caregiver changes frequently
No	45 (38.8)	1.00	1.00
Yes	2 (25.0)	0.64 (0.19–2.19)	0.57 (0.17–1.88)
Caregiver is elderly
No	30 (35.7)	1.00	1.00
Yes	17 (42.5)	1.19 (0.75–1.89)	1.00 (0.63–1.60)
Caregiver is ill, requires care
No	44 (37.9)	1.00	1.00
Yes	3 (37.5)	0.99 (0.39–2.49)	0.94 (0.37–2.38)
Caregiver is unsupportive
No	42 (37.8)	1.00	1.00
Yes	5 (38.5)	1.02 (0.49–2.10)	0.82 (0.41–1.66)
Caregiver financial difficulty
No	38 (36.2)	1.00	1.00
Yes	9 (47.4)	1.31 (0.76–2.24)	1.29 (0.79–2.09)
Travel-related factors
Long distance to clinic
No	19 (40.4)	1.00	1.00
Yes	28 (36.4)	0.90 (0.57–1.42)	1.00 (0.61–1.64)
Transport fee is expensive
No	30 (35.7)	1.00	1.00
Yes	17 (42.5)	1.19 (0.75–1.89)	1.30 (0.79–2.13)
Not enough time for visits
No	38 (35.5)	1.00	1.00
Yes	9 (52.9)	1.49 (0.89–2.50)	1.27 (0.78–2.09)
Psychosocial factors
Visits noticed by community
No	38 (39.2)	1.00	1.00
Yes	9 (33.3)	0.85 (0.47–1.53)	0.75 (0.41–1.39)
Visits noticed by school/peer
No	29 (34.5)	1.00	1.00
Yes	18 (45.0)	1.30 (0.83–2.05)	1.21 (0.76–1.93)
Distrust health care workers
No	45 (38.5)	1.00	1.00
Yes	2 (28.6)	0.74 (0.23–2.45)	0.84 (0.25–2.76)
Disclose status to family
No	3 (50.0)	1.00	1.00
Yes	44 (37.9)	0.76 (0.33–1.75)	0.62 (0.26–1.50)
Disclose status to school/peer
No	34 (41.0)	1.00	1.00
Yes	13 (32.5)	0.79 (0.47–1.33)	0.66 (0.40–1.09)
Health care facility factors
Long waiting queues at clinic
No	38 (43.7)	1.00	1.00
Yes	9 (24.3)	0.56 (0.30–1.03)	0.54 (0.30–0.99)
Inconvenient clinic hours
No	38 (36.9)	1.00	1.00
Yes	9 (42.9)	1.16 (0.67–2.02)	1.20 (0.70–2.05)
Unfriendly health care workers
No	44 (36.7)	1.00	1.00
Yes	3 (75.0)	2.05 (1.11–3.77)	1.61 (0.81–3.17)
No sexual health services
No	41 (37.3)	1.00	1.00
Yes	6 (42.9)	1.15 (0.60–2.21)	1.26 (0.69–2.30)
Lack of peer support
No	41 (36.9)	1.00	1.00
Yes	6 (46.2)	1.25 (0.66–2.36)	0.93 (0.48–1.82)
Treatment-related factors
Having problems taking ART
No	33 (33.0)	1.00	1.00
Yes	14 (58.3)	1.77 (1.14–2.74)	1.45 (0.91–2.32)
Treatment fatigue
No	32 (32.7)	1.00	1.00
Yes	15 (57.7)	1.77 (1.14–2.73)	1.47 (0.94–2.31)

Risk ratios individually adjusted for age, gender, mother as caregiver, and time on ART.