MGHD 2018

Background: Since the introduction of the Treat-All Policy, treatment is given to every HIV positive person in Rwanda regardless any other eligibility criteria. Studies done in Rwanda demonstrated that adolescents present treatment failure compared to adult; level of adherence to treatment has been proven to be a predictor of patient outcome. This study aimed at exploring factors that are associated with poor adherence among adolescents enrolled on HIV treatment in two district hospitals in rural Rwanda. Method: A mixed methods approach was used to determine the levels of adherence and explore its risk factors. Participants were identified from electronic medical record, and self-report data were collected using a pre-designed questionnaire. In-depth interviews were conducted to explore the factors associated with poor outcomes. Adherence level was measured at two levels: Appointment keeping and treatment adherence. Results: A total of 139 adolescents were identified from EMR. 58% of all registered adolescent had good appointment keeping. Of the registered ones 72 voluntarily responded to the self-report questionnaire. Of the 72 who voluntarily responded to the self report questions, 87% reported adhering to treatment at the level of 95% and above; 13% had poor adherence over 30 days prior to the reporting day. 53% of the respondents had good adherence of having taken drugs at 95% level and 47% presented with poor adherence within 3 days prior to the reporting day. Poverty, stigma, and Orphanage was the leading causes of poor adherence. Conclusion: The level of adherence to HIV treatment is low among adolescents and youth in rural Rwanda; collaboration between health care providers, local government and the community is needed to design a community-based approach to respond to the poor adherence among adolescents in rural Rwanda.