Antiretroviral Therapy Adherence, Dietary Practices and Nutrition Status of Adolescents Attending Kiambu Level 5 Hospital, Kiambu County, Kenya
Loading...
Date
2025-09
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Adolescents living with HIV face challenges in maintaining adherence to antiretroviral therapy (ART), adopting appropriate dietary practices, and achieving optimal nutritional status. In Kenya, adolescent HIV prevalence is 4.44%, with Kiambu County reporting 5.6%, placing it among the six most affected counties. This study assessed ART adherence, dietary practices, and nutritional status among adolescents living with HIV attending Kiambu Level Five Hospital. A cross-sectional design was used, with data collected from 271 adolescents aged 10–19 years through structured questionnaires, 24-hour dietary recall, anthropometric measurements, and focus group discussions (FGDs). Systematic random sampling was used for quantitative data, and purposive sampling for the FGD. Quantitative data were analysed using SPSS version 23 and NutriSurvey, with chi-square tests and logistic regression used to determine associations and predictors. Participants were 51.3% male and 48.7% female, mean age 15.6 years. Most (74.9%) were in secondary school, and 50.2% lived in households with ≤6 members. Socio-economically, 74.5% lived in rented houses and 52.4% of caregivers worked in the informal sector. ART adherence was moderate to high in 56.2%, while 43.8% had poor adherence. Dietary diversity was low in 38.1%, medium in 41.9%, and high in 20.0%, with many showing micronutrient inadequacies. Nutritional assessment revealed 15.2% underweight, 74.3% normal weight, and 10.5% overweight/obese. Chi-square analysis showed significant associations between nutritional status and both ART adherence (p = 0.013) and dietary diversity (p = 0.003). Logistic regression identified ART adherence (AOR = 2.31; 95% CI: 1.14–4.65; p = 0.020) and dietary diversity (AOR = 2.89; 95% CI: 1.41–5.93; p = 0.004) as independent predictors of normal nutritional status. Caregiver education and household income were also significantly associated with dietary practices and nutritional outcomes. Qualitative findings highlighted stigma, school schedules, and limited adolescent-friendly services as barriers to adherence, while food insecurity and inadequate nutrition knowledge constrained dietary diversity. The study concludes that ART adherence and dietary diversity are significant, modifiable determinants of nutritional status among adolescents living with HIV in Kiambu County. It recommends integrating targeted nutrition education into adolescent HIV care, enhancing adherence counselling through peer support and flexible clinic schedules, and strengthening caregiver engagement. Policy measures should institutionalize routine nutrition assessment, foster multi-disciplinary care, and promote caregiver economic empowerment to address food insecurity. Further research should explore long-term effects of integrated interventions and evaluate the role of school-based programs in improving adolescent health outcomes
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science (Food, Nutrition, and Dietetics) in the School of Health Sciences of Kenyatta University, September, 2025
Supervisor:
1.Winfreda Nyamota
2.Regina Kamuhu