Assessing community factors associated with Antiretroviral Therapy (ART) defaulting among youth accessing HIV care in Mzimba District, Malawi

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Abstract Introduction/Background ART defaulting has been associated with increased morbidity and mortality of HIV positive youth. Youth that default tend to develop drug resistance and resurgence of opportunistic infections. They can also transmit drug resistant strains of HIV to others through unprotected sexual intercourse. This study, therefore, aims at assessing community factors influencing ART defaulting amongst HIV positive youth enrolled on ART in Mzimba District. Material and Methods This study utilized a quantitative, case control design. A sample of 411 HIV positive youth (n=137 cases and n=274 controls) attending an HIV care clinic was recruited. Both ART defaulters and non-defaulters were enrolled using random sampling technique. Data were collected using a structured questionnaire and analyzed using the Statistical Package for Social Scientists (SPSS) version 20.0. Descriptive statistics were used to provide count, frequencies, proportions and ranges while inferential statistics were used to establish association between dependent variable with independent variables. Results Results from this study indicate that lack of community social support ( p < 0.001, OR: 11.257, 95% CL: 6.782-18.686), long distance to ART clinics ( p : 0.002, OR: 2.454, 95% CL: 1.511-3.985) and migration of the youth other countries ( p: 0.001, OR: 35.661, 95% CL: 4.675-272.049) are statistically significant factors to ART defaulting among the study participants who are youth in Mzimba District in Malawi. Conclusion The study conclusively proved that lack of community social support, forgetfulness and going to RSA for employment influenced defaulting to antiretroviral therapy among the youth in Mzimba, Malawi. The researcher recommends introduction of community ART outreach programs to help in reducing defaulting among the youth. Further, policy review to provide for technology that enables free ARVs regardless of national identity (ID) documents requirements and cross-border collaboration in managing HIV among the youth on ART between countries to ensure continuity of care.

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