The role of family factors in antiretroviral therapy (ART) adherence self-efficacy among HIV-infected adolescents in southern Uganda

摘要

BACKGROUND:Adolescents living with HIV in sub-Saharan Africa are a vulnerable group at the intersection of poverty and health disparities. The family is a vital microsystem that provides financial and emotional support to achieve optimal antiretroviral therapy (ART) adherence. In this study, we explore the association between family factors and ART adherence self-efficacy, a significant psychological concept playing a critical role in ART adherence.METHODS:Data from an NIH-funded study called Suubi?+?Adherence, an economic empowerment intervention for HIV positive adolescents (average age?=?12.4?years) in southern Uganda was analyzed. We conducted multilevel regression analyses to explore the protective family factors, measured by family cohesion, child-caregiver communication and perceived child-caregiver support, associated with ART adherence self-efficacy.RESULTS:The average age was 12.4?years and 56.4% of participants were female. The average household size was 5.7 people, with 2.3 children?18?years. Controlling for sociodemographic and household characteristics, family cohesion (β?=?0.397, p?=?0.000) and child-caregiver communication (β?=?0.118, p?=?0.026) were significantly associated with adherence self-efficacy to ART.CONCLUSION:Findings point to the need to strengthen family cohesion and communication within families if we are to enhance adherence self-efficacy among adolescents living with HIV.TRIAL REGISTRATION:This trial was registered with ClinicalTrials.gov (registration number: NCT01790373) on 13 February 2013.