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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    ABSTRACT: Our objective was to study the impact of physical, psychological and socio-economic factors on the quality of life (QL) of HIV-infected children and their effect on antiretroviral therapy (cART) adherence. We carried out a multicentre pilot, cross-sectional research in a cohort of 71 HIV-infected children (HIV-group) from three Hospitals in Madrid (Spain) and 34 healthy children (non-HIV-group) from public schools of the same neighbourhood of this city. The children were between 5 and 14 years old. To determine the perceived QL, the Spanish version of the child health profile (CHIP-CE) questionnaire was used. The socio-environmental dimension of the QL was measured via semi-structured interviews. The indirect method of semi-structured family interview was used to study the cART adherence. The HIV-group did not show differences in comparison with the non-HIV-group when they had a high perception of their health status and wellbeing. However, the HIV-group showed a worse ‘emotional comfort’, a lower level in the ‘satisfaction with self’ and in the ‘concentration ability’, a lower evaluation of family relationships and was more prone to perform with threat to achievements and to perform ‘individual risk avoidance’ than non-HIV-group. This work showed that the impact of HIV infection in children extends to all aspects of the QL, including physical, psychological, socio-educational and family, being associated with worse clinical outcomes in HIV/AIDS and had a negative effect on cART adherence in children. Summing up, the HIV-group had a poor perception of the overall QL.
    Vulnerable Children and Youth Studies 02/2015; 10(2):163-177. DOI:10.1080/17450128.2015.1026866