FACTORS ASSOCIATED WITH GOOD THERAPEUTIC ADHERENCE AMONG CHILDREN UNDER 15 LIVING WITH HIV AT THE MOTHER AND CHILD UNIVERSITY HOSPITAL OF N'DJAMENA

Introduction: Therapeutic adherence is a key determinant of the effectiveness of antiretroviral (ARV) treatment in children living with the human immunodeficiency virus (HIV). The aim of this study was to identify the factors associated with good adherence in order to guide interventions to improve pediatric management. Patients and Methods: This was a cross-sectional study conducted from December 5, 2023, to May 30, 2024, in the Department of Pediatrics of the Mother and Child University Hospital of N’Djamena. Children under 15 years of age living with HIV and on ARV therapy for at least six months were included. Adherence was assessed using a composite score combining self-reporting, pill count, and regularity of visits. Associated factors were analyzed using multivariate logistic regression. Results: A total of 210 children were included. The overall rate of good adherence (≥95%) was 72.4%. Factors associated with good adherence included a tutor’s secondary or higher education level (OR=2.1; p=0.03), parental support (OR=3.2; p=0.001), disclosure of HIV status to the child (OR=2.3; p=0.01), a simple therapeutic regimen (once-daily dosing) (OR=2.9; p=0.002), and regular follow-up visits (OR=3.8; p<0.001). Conclusion: Family involvement, therapeutic education, simplified regimens, and regular medical follow-up are major determinants of adherence. Strengthening these interventions could improve survival and quality of life among children living with HIV.