Currently submitted to: JMIR Formative Research
Date Submitted: Oct 22, 2026
Open Peer Review Period: Oct 23, 2026 - Dec 18, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Non-Adherence to Antiretroviral Treatment Among People Living with HIV in Kinshasa, Democratic Republic of Congo: A Cross-Sectional Analytical Study
ABSTRACT
Background:
Inadequate adherence to antiretroviral therapy compromises viral suppression, promotes the emergence of antiretroviral resistance, and increases the risk of treatment failure. Despite progress in HIV care, recent data on non adherence and its determinants in Kinshasa remain limited.
Objective:
This study aimed to estimate the prevalence of non-adherence and to identify the factors associated with it among people living with HIV receiving care at healthcare facilities in the city of Kinshasa.
Methods:
A cross-sectional study was conducted from September 10 to October 30, 2024, among 475 people living with HIV, aged 18 years or older, who had been receiving antiretroviral therapy for at least 6 months. Participants were selected using three-stage stratified sampling. Therapeutic adherence was assessed using two complementary approaches: the CASE index and the renewal of antiretroviral prescriptions an overall measure of adherence was then obtained by combining the two methods. Associated factors were identified using multivariate logistic regression. Adjusted odds ratios (ORa) and their 95% confidence intervals (95% CI) were reported
Results:
Among the 475 participants included, the mean age was 43.5 ± 12 years. The prevalence of non-adherence was 14.1% according to the subjective method, 9.7% according to the objective method, and 23.8% according to the overall measure. After adjustment, the factors independently associated with non-adherence were being aged 18–29 years (ORa = 3.2, 95% CI [1.4–7.3], p = 0.004); medication interfering with daily activities (ORa = 6.2, 95% CI [2.8–13.6], p < 0.001); failure to achieve viral suppression (ORa = 3.7, 95% CI [2.0–6.6], p < 0.000).
Conclusions:
Nearly one-quarter of people living with HIV on antiretroviral therapy in Kinshasa were non-adherent to their treatment. Interventions targeting young adults and adapting treatment regimens to the constraints of daily life could help improve treatment adherence and promote sustained viral suppression.
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