Factors Influencing Adherence to Pediatric Antiretroviral Therapy: Experience from a Tertiary Care Center in Oman.

Introduction Antiretroviral therapy (ART) compliance is essential for successful treatment outcomes of children living with human immunodeficiency virus (HIV) infection. The factors affecting adherence to ART, which have not yet been explored in Oman for children living with HIV infection, must thus be investigated. Methods A cross-sectional study was conducted that included all children living with HIV who were receiving care at the pediatric infectious disease clinics of Royal Hospital, a tertiary care center, and who had been on pediatric antiretroviral therapy (ART) formulations for more than one year. After receiving informed consent, 43 caregivers of HIV-positive children were interviewed using a questionnaire. Patients' characteristics, socioeconomic, pharmacological, and health care system factors were analyzed in correlation with adherence to ART using SPSS version 26 (IBM Corp., Armonk, USA). Results Thirty percent of patients (n=13) had high HIV viral loads, and among those, 19% (n=8) had suboptimal adherence. Young and non-educated caregivers, low income, and lack of transportation were significant factors for poor adherence to ART therapy, with a significant p-value. Other important factors noticed were medication not available at home, missed medication refills, and a child's busy schedule at school, and patients' caregivers did not always administer the prescribed medications. Conclusion The study results support the recommendation to provide a pediatric formulation of ART and supply it to peripheral secondary care hospitals for easy access to medications. Psychological assessments and counselling at the adolescent medicine clinic in the same centre would aid caretakers psychologically and gauge children with HIV's preparedness for disease disclosure.