Research Article

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

Table 4

Factors associated with prevalent virologic failure among adolescents with a recorded VL measurement .

Variable
(%) with prevalent VL failureCrude risk ratio (95% CI)Adjustedrisk ratio (95% CI)

Baseline and demographic factors
Gender
 Female16 (27.1%)1.001.00
 Male16 (36.4%)1.54 (0.66–3.56)1.44 (0.76–2.73)
Age group (years)
 12–1411 (25.6%)1.001.00
 15–1711 (37.9%)1.78 (0.64–4.91)2.67 (0.76–9.34)
 18–2010 (32.3%)1.39 (0.50–3.83)2.77 (0.51–14.96)
Highest school level
 Secondary14 (35.0%)1.001.00
 Primary14 (25.9%)0.65 (0.27–1.58)1.17 (0.28–4.79)
Dwelling type
 Formal26 (32.9%)1.00
 Care facility1 (9.1%)0.20 (0.02–1.68)
 Informal5 (38.5%)1.27 (0.38–4.28)
Mother caregiver
 No15 (31.3%)1.00
 Yes17 (30.9%)0.98 (0.43–2.27)
Caregiver employed
 No10 (35.7%)1.00
 Yes21 (32.3%)0.86 (0.34–2.18)
Caregiver-related factors
Caregiver changes frequently
 No32 (32.7%)1.00
 Yes0 (0.0%)
Caregiver is elderly
 No22 (30.6%)1.001.00
 Yes10 (32.3%)1.08 (0.44–2.67)1.31 (0.69–2.48)
Caregiver is ill, requires care
 No29 (29.9%)1.001.00
 Yes3 (50.0%)2.34 (0.45–12.31)0.65 (0.09–4.55)
Caregiver is unsupportive
 No28 (30.8%)1.00
 Yes4 (33.3%)1.13 (0.31–4.05)
Caregiver financial difficulty
 No26 (30.2%)1.001.00
 Yes6 (35.3%)1.26 (0.42–3.77)2.51 (0.51–12.38)
Travel-related factors
Long distance to clinic
 No11 (28.2%)1.001.00
 Yes21 (32.8%)1.24 (0.52–2.97)0.43 (0.18–1.04)
Transport fee is expensive
 No20 (27.8%)1.001.00
 Yes12 (38.7%)1.64 (0.68–3.99)1.79 (0.76–4.19)
Not enough time for visits
 No28 (31.1%)1.00
 Yes4 (30.8%)0.98 (0.28–3.47)
Psychosocial factors
Visits noticed by community
 No32.9% (26)1.001.00
 Yes25.0% (6)0.68 (0.24–1.92)0.37 (0.15–0.93)
Visits noticed by school/peer
 No31.4% (22)1.001.00
 Yes30.3% (10)0.95 (0.39–2.33)1.02 (0.44–2.37)
Distrust health care workers
 No30.3% (30)1.001.00
 Yes50.0% (2)2.30 (0.31–17.10)6.15 (1.14–33.24)
Disclose status to family
 No33.3% (1)1.001.00
 Yes31.3% (31)0.91 (0.08–10.44)1.34 (0.39–4.63)
Disclose status to school/peer
 No34.3% (24)1.001.00
 Yes25.0% (8)0.64 (0.25-1.64)0.51 (0.20–1.26)
Health care facility factors
Long waiting queues at clinic
 No27 (35.5%)1.001.00
 Yes5 (18.5%)0.41 (0.14–1.21)0.94 (0.28–3.12)
Inconvenient clinic operating hours
 No28 (32.6%)1.001.00
 Yes4 (23.5%)0.64 (0.19–2.13)0.49 (0.16–1.52)
Unfriendly health care workers
 No32 (31.4%)1.00
 Yes0 (0.0%)
No sexual health services
 No28 (31.1%)1.001.00
 Yes4 (30.8%)0.98 (0.28–3.47)0.70 (0.19–2.50)
Lack of peer support
 No31 (33.0%)1.00
 Yes1 (11.1%)0.25 (0.03–2.12)
Treatment-related factors
Having problems taking ART
 No26 (31.3%)1.001.00
 Yes6 (30.0%)0.94 (0.32–2.72)0.36 (0.16–0.82)
Treatment fatigue
 No23 (28.4%)1.001.00
 Yes9 (40.9%)1.75 (0.66–4.64)1.71 (0.78–3.75)

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