Caregivers’ support for children‘s Anti-Retroviral therapy (ART) adherence in the Eastern Amhara region, Northeastern Ethiopia: a cross-sectional institutional study

Adherence to antiretroviral therapy (ART) is essential for effective HIV management in children. Poor adherence can lead to increased viral replication, treatment failure, and development of drug-resistant HIV. Parents and caregivers play a central role in supporting adherence. A cross-sectional study was conducted from 1 May to 30 June 2023, involving 411 participants selected through simple random sampling. Data were collected using an interviewer-administered questionnaire, and associations were examined using multivariate logistic regression. The overall ART adherence rate among children was 82% (339/411). Lower adherence was significantly associated with having non-biological parents (Adjusted OR = 9.81; 95% CI: 2.3-43.74), lack of communication between parents and children (Adjusted OR = 3.92; 95% CI: 1.27-12.04), poor relationships between parents and healthcare providers (AOR = 29.592; 95% CI: 11.33-66.33), inadequate caregiver support (Adjusted OR = 5.92; 95% CI: 3.27-6.04), and having more than four siblings (Adjusted OR = 5.68; 95% CI: 2.10-15.34). Improving adherence requires strengthening parent-child communication and improving caregiver-healthcare provider relationships to support HIV-infected pediatric populations.