Abstract
Background
 HIV continues to be an important public health concern among adolescents. To reduce the high rate of mortality and improve the quality of life among people with HIV, WHO guidelines emphasize the early initiation of ART drugs in HIV-infected persons regardless of their CD4 count and clinical status. However, adherence to ART remains low in adolescents between 10 to 19 years from low and middle-income countries (LMICs).
 Objective
 To determine the factors influencing adherence to ART among adolescents with HIV in Rwanda.
 Method
 A cross-sectional design using proportional stratified random sampling to select 166 adolescents was conducted. Data were analyzed using descriptive and inferential statistics with a p-value <0.05 and a CI of 95%.
 Results 
 The overall adherence to ARTs was 38%. Assistance of clinical staff in taking medication (p<0.001) and the help of parents in taking medication (p<0.001) positively influenced adherence to ART. Insufficient health care providers, forgetfulness (p=0.009), and dosage too complex (p=0.044) negatively influenced adherence to ART.
 Conclusion
 Factors such as someone reminding adolescents to take medication, non-stigmatization, and absence of side effects were positively associated with ART adherence. On the other hand, forgetfulness, complex dosage, being isolated and inadequate education about medications negatively affect adherence to ARTs. There is a need to set strategies to increase adherence to ARTs, including expert clients and trustable guardians in care provision. All adolescents should receive adequate counselling and health education before the initiation of ARTs.
 Rwanda J Med Health Sci 2022;5(3):251-263
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