Antiretroviral therapy status and factors associated with ART use among orphaned and vulnerable children (OVC) living with HIV in Namibia

This study assessed the antiretroviral therapy (ART) status and factors associated with ART use among Children and adolescents living with HIV (C/ALHIV) enrolled in the Namibia OVC program. This retrospective cross-sectional secondary analysis study used data collected at enrolment of C/ALHIV participating in the OVC program, implemented by Project HOPE Namibia (PHN) from 1 August 2023. Data were analyzed utilizing IBM Statistical Package for Social Sciences (SPSS) version 29. Among the 4599 participants included in this analysis, 4441 (96.6%) participants were on ART, with a 95% confidence interval (CI) (96.1% − 97.1%). Participants more likely to be on ART were from households with little or no hunger (Crude Odds Ratio (COR) = 2.19, 95% CI (1.40 – 3.43)), from Eenhana (adjusted odds ratio (AOR) = 8.24, 95% CI (2.58 – 26.37)), Engela (AOR = 3.72, 95% CI (1.63 – 8.50)), Okongo (AOR = 5.22, 95% CI (1.22 – 22.38)), Oshakati (AOR = 2.50, 95% CI (1.04 – 6.01)), and Oshikuku (AOR = 3.70, 95% CI (1.18 – 11.55)). In contrast, participants who were less likely to be on ART were aged 0–9 years, never enrolled at a school (COR = 0.26, 95% CI (0.18 – 0.37)), and were diagnosed or presumed to be with TB (AOR = 0.10, 95% CI (0.01 – 0.73)). Additionally, participants from child-headed households, those who were sexually abused or sexually exploited, were less likely to be on ART, COR = 0.02, 95% CI (0.01 – 0.03), COR = 0.04, 95% CI (0.02 – 0.06), and COR = 0.12, 95% CI (0.10 – 0.15), respectively. The findings indicate that integrating food support into HIV programs may enhance ART uptake among C/ALHIV. Strategies should be implemented to improve the enrolment for OVC in educational institutions.