Adherence to antiretroviral therapy of Brazilian HIV-infected children and their caregivers

Braz J Infect Dis. 2016 Sep-Oct;20(5):429-36. doi: 10.1016/j.bjid.2016.05.009. Epub 2016 Jul 26.

Abstract

Background: Successful treatment of HIV-positive children requires a high level of adherence (at least 95%) to highly active antiretroviral therapy. Adherence is influenced by factors related to the child and caregivers.

Objectives: To evaluate children and caregivers characteristics associated to children's adherence.

Methods: Cross-sectional study, from September 2013 to June 2015, comprising a sample of caregivers of perinatally HIV-infected children, in the age group of 1-12 years, under antiretroviral therapy for at least 6 months and on follow-up in two AIDS reference centers in Salvador, Bahia. Caregiver self-reports were the sole source of 4 days adherence and sociodemographic information. Study participants who reported an intake >95% of prescribed medication were considered adherents. A variable, ("Composed Adherence"), was created to better evaluate adherence.

Results: We included 77 children and their caregivers. 88.3% of the caregivers were female, the median age was 38.0 years (IQR 33.5-47.5), 48.1% were white or mixed, 72.7% lived in Salvador and 53.2% had no fixed income. The 4 days child's adherence was associated only to caregivers that received less than a minimum salary (p<0.05), 70.1% of the caregivers had less than four years of formal education, 81.8% were children's relative and 53.2% of the caregivers were HIV positive. The caregiver's pharmacy refill, long-term adherence and 4 days adherence, were significantly associated with composed adherence (p<0.05). Child's long-term adherence was strongly associated to the 4 days child's adherence referred by caregiver (p<0.001).

Conclusions: Our results suggest the need of improvement in HIV-infected children adherence, through reinforcement of the caregivers own adherence.

Keywords: Adherence; Antiretroviral therapy; Caregivers; Children.

MeSH terms

  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active / statistics & numerical data*
  • Assessment of Medication Adherence*
  • Brazil
  • Caregivers / statistics & numerical data*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • HIV Infections / drug therapy*
  • Humans
  • Infant
  • Male
  • Self Report
  • Socioeconomic Factors
  • Statistics, Nonparametric
  • Time Factors
  • Viral Load

Substances

  • Anti-HIV Agents