Adherence to antiretroviral treatment in children at the Center of Excellence for the care of people living with HIV/AIDS at the University of Lubumbashi in the Democratic Republic of Congo

Introduction: Treatment adherence among children living with HIV is a major challenge in sub-Saharan Africa. In the Democratic Republic of Congo, pediatric antiretroviral therapy coverage remains low, with marked disparities related to sex, parental status, and age. Methodology: A retrospective descriptive study was conducted at the Center of Excellence of the University of Lubumbashi, covering 158 medical records of children aged 2 to 14 years under ARV treatment between 2015 and 2020. Sociodemographic, clinical and virological variables were analyzed, and statistical tests (chi-square, Student, multivariate regression) were used to identify the determinants of adherence. Results: The study revealed treatment interruption in 19% of cases, more frequent in boys (21.1%) and in children with undetermined parental status (33.3%). Adolescent girls (11–15 years) were overrepresented (43%) but had better viral suppression. Conversely, boys showed a higher prevalence of detectable viral loads. The absence of virological data correlated with a more frequent treatment interruption (33.3%), reflecting possible undocumented losses to follow-up or deaths. Conclusion: Pediatric treatment adherence is influenced by complex factors, including gender, psychosocial context, and follow-up regularity. Gender-differentiated interventions, supported by community programs, are essential to improve retention in care and ensure long-term therapeutic effectiveness.