Patient related factors associated with ART defaulting among the youth accessing HIV care services in Mzimba, Malawi

Antiretroviral therapy (ART) defaulting is a serious problem among youth
accessing Human immunodeficiency virus (HIV) care services in Malawi. It leads
to development of drug resistance, treatment failure and increased client
mortality. This study aimed at assessing patient factors influencing ART
defaulting amongst youth living with HIV enrolled on ART in Mzimba District.

<b>Methods:</b> A quantitative, case-control
design was employed, enrolling 411 youths living with HIV (n=137 cases and
n=274 controls) attending an HIV care clinic. The cases and controls were
allotted to the ART clinics proportionally to their number of ART clients. Random
sampling techniques were used to recruit both ART defaulters and
non-defaulters. Data were collected using a structured questionnaire and
analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Descriptive
statistics provided counts, frequencies, proportions, and ranges, while
inferential statistics established associations between dependent and
independent variables.

<b>Results:</b> Patient
related factors associated with ART defaulting include: forgetting appointment
date (p-value: &lt;0.001, OR: 4.213, 95% CL: 2.289-7.755), experiencing ART
side effects (p-value: &lt;0.001, OR: 0.438, 95% CL: 0.286-0.672), taking other
drugs apart from ARVs (p-value 0.008, OR: 0.059, 95% CL: 0.007-0.479). ART
defaulting was also associated with presence of a psychological disorder among
the participants (SRQ statement 7_8) (p-value &lt;0.001, OR: 22.119, 95% CL:
10.81-45.26) and having suicidal ideas in the participants (p-value
&lt;0.001, OR: 0.111, 95%CL: 0.051-0.241). Seventeen percent (17%)
of the youths had psychological disorders, 10% suicidal thoughts, 20.0%
anxiety, 12.4% felt worthless, 19.2% troubled mind, 24.8% headache and
abdominal discomfort (23.8%)