Pediatric adherence to HIV Antiretroviral therapy

Massachusetts General Hospital Center for Global Health, Harvard Initiative for Global Health, 3rd floor, Cambridge, MA 02138, USA.
Current HIV/AIDS Reports 11/2009; 6(4):194-200. DOI: 10.1007/s11904-009-0026-8
Source: PubMed

ABSTRACT More than 2 million children are infected with HIV globally. Pediatric antiretroviral therapy (ART) adherence is complex, and current levels are often suboptimal. As established treatment programs in developed settings struggle with chronic therapy and nascent treatment programs in resource-limited settings expand, the importance and challenges of good adherence to ART are becoming ever more clear. Adherence behavior is influenced by many factors, which may be categorized as characteristics of the child, the caregiver(s) and family, the regimen, and society and culture. Many of these influences complicate measurement of pediatric adherence, and there is no gold standard. This article provides a conceptual framework and evidence-based look at the factors influencing ART adherence in children and aims to identify areas for intervention for this vulnerable population in need.

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    • "Conceptualising social capital in terms of the networks and norms that characterise local communities in which children and their carers live, we examine the link between social capital and children's adherence to ART in a low income setting, and outline our evolving conceptualisation of an 'adherence-competent community'—defined as those social relations that enable and support the likelihood of optimal adherence despite poverty and social disruption. HIV care and treatment is complex and drug regimens must be carefully adhered to, requiring consistent and meticulous monitoring (Steele and Grauer, 2003; van Rossum et al., 2002) and the support of various actors, frameworks and systems, including the child, guardian , community members, the child's cultural heritage and the health care system available (Haberer and Mellins, 2009; Vreeman et al., 2009). It is critical that children in resource-poor settings stay on affordable, readily available and first choice treatment (first-line drugs) for as long as possible. "
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