Non-adherence to anti-retroviral therapy among children living with HIV: Perspectives of family caregivers

The advent of antiretroviral therapies (ART) has improved the treatment of Human Immunodeficiency Virus (HIV) among people including children living with the condition globally. Non-adherence among children living with HIV has attracted attention in literature and many studies have delved into the factors causing high non-adherence of ART among people with HIV. Family caregivers of children living with HIV (CLWH) form an important group as their actions or inactions play a major role in the health outcomes of their wards. Considering the limited studies conducted among this key stakeholder, the current study sought to explore the factors that contributes to non-adherence of ART among their CLWH. An exploratory phenomenological study was conducted among 15 purposively sampled caregivers of non-adherent CLWH whose wards were receiving treatment at the ART clinic of a government hospital in Kumasi, Ghana. Participant’s consent was sought and a semi-structured interview guide aided in exploring the factors that contributed to ART non-adherence among their CLWH. The data was transcribed verbatim and inductively analysed into themes. Participants comprised of 11 females and 4 males, aged between 28 to 48 years. Eleven (11) of the participants were biological parents of their wards and four themes were generated from the data. “Knowledge of caregivers” described the level of understanding participants had concerning causes, symptoms and treatment of HIV/AIDS. “Challenges of care” described issues that resulted in non-adherence such as drug-related side effects, health system-related issues and caregiver/child-related issues. Socioeconomic factors described the financial barriers to care, and social issues such as isolation and stigmatization induced stress. A plethora of factors affects CLWH’s non-adherence to ART and this requires sustained, multifaceted approaches to improve this worrying occurrence. Sensitization of caregivers of CLWH on the health challenge of non-adherence is critical in ensuring adherence for improved well-being of their wards.