Antiretroviral Therapy Adherence and Associated Factors Among Adolescents Living With HIV Aged 10-15 During the Covid-19 Pandemic: A Multicentre Cross-Sectional Study in Vietnam

Abstract Background Adherence to antiretroviral therapy (ART) is essential for achieving viral suppression, preventing HIV-related complications, and improving long-term health outcomes. However, maintaining optimal adherence remains challenging among adolescents living with HIV (ALHIV). Objectives To evaluate the ART adherence and investigate the factors associated with ART non-adherence among ALHIV aged 10–15 years at five hospitals in Vietnam. Methods A cross-sectional study was conducted among 618 ALHIV aged 10–15 years receiving ART at five hospitals in Vietnam from May 2020 to October 2021. Data were collected through quarterly structured interviews and periodic medical record reviews. ART adherence was assessed using the average adherence across quarterly assessments. Non-adherence to ART was defined as an adherence level < 95%. Results Overall, 189 of 618 participants (30.6%) were classified as nonadherent. The most common reason for non-adherence was a lack of drugs at scheduled clinic visits (42.9%). ART adherence was significantly higher among those who initiated ART after 1–12 months of HIV diagnosis compared to within one month [AOR 0.58 (0.37–0.92)]. Virological treatment failure with viral load of 1.000-100.000 copies/mL at baseline was a risk factor for nonadherence [AOR 3.95 (1.30–11.9)] and those receiving HIV care at hospitals in Southern Vietnam [AOR 0.25 (0.15–0.44)]. Adolescents with married caregivers [AOR (0.57 (0.38–0.85)] had lower odds of nonadherence. Conclusion ART nonadherence remains common among adolescents living with HIV. Strengthening adherence preparation at ART initiation and providing ongoing support for caregivers may improve long-term treatment adherence and decrease virological treatment failure.