Factors Associated with Antiretroviral Therapy Adherence Among Adolescents Living with HIV in Eastern Cape Province

Suboptimal ART adherence contributes to treatment failure and is common among adolescents. The study sought to assess factors associated with antiretroviral therapy (ART) adherence among adolescents living with HIV. This was a retrospective cross-sectional study design with a random sample of 137 records of adolescents aged 10-19 years from four high-volume ART sites (35 records per site). Data was collected using a customized data extraction tool. Descriptive statistics and Fisher's exact tests were used to analyze data and identify factors associated with ART adherence at 5% significance level. Most participants (80.3%) were females. Females were more likely to access ART literacy information than males (<i>p</i> = 0.033); poor ART outcomes were prevalent, characterized by high unsuppressed viral loads (73%), low status disclosure (49.6%), inadequate treatment support-lack of treatment buddies (51.2%), missed scheduled ART-related appointments (97.1%), and low rates of follow-up visits (1.5%). Some adolescents (36.5%) rely on alternative medication for HIV treatment. In conclusion, targeted interventions must focus on improving ART adherence, strengthening support systems, and promoting disclosure among adolescents living with HIV, including addressing the use of unproven HIV therapies.