Barriers to Antiretroviral Therapy Adherence Among Children in Ekurhuleni, South Africa: A Descriptive Study

Abstract

This study aimed to explore and describe the barriers to Antiretroviral Therapy (ART) adherence among children in Ekurhuleni, Gauteng. A quantitative, cross-sectional design using a survey method was employed. Convenience sampling was used to recruit 157 parents, guardians, and caregivers (PGCs) who consented to participate in the study. Data was collected using self-report questionnaires and analysed using descriptive statistics and frequency distributions. The study was not designed or statistically powered to formally test associations between variables; therefore, only descriptive statistical analyses were conducted. The reliability and validity of the instrument were ensured, and ethical clearance was obtained from the relevant authorities prior to data collection. The study was conducted in accordance with established ethical principles and in compliance with the Declaration of Helsinki. The findings revealed that there were multiple barriers to children's adherence to ART. Approximately one-third of PGCs reported being fully informed about the importance of ART adherence, while the majority indicated being only partially informed. Missed doses emerged as a significant challenge, with a substantial proportion reporting missed medication on one or more days, and only 31.2% administering ART consistently on time. Difficulties in understanding blood test results were also reported. In addition, a notable proportion of PGCs admitted to missing clinic appointments. These findings emphasize the need for strengthened caregiver education, ongoing support, and tailored interventions directed at primary health care nurses to promote consistent ART adherence among children.