No abstract

The purpose of this study was to compare and contrast three different methods for measuring self-reported antiretroviral medication adherence, correlate individual reports of adherence with measures of viral load, and identify the degree of concordance among self-reported medication adherence tools. Thirty-five adolescents between the ages of 11 and 21 years (mean age, 15.4) enrolled in National Cancer Institute (NCI) HIV primary treatment protocols participated in the study. Adherence approaches consisted of a clinical nurse rating (CNR), a Retrospective Self-Report Interview (RSI; using two different scoring criteria), and a 24-hour recall phone interview (Daily Phone Diary [DPD]). These were chosen because of their potential to be integrated within a clinical setting. Reported perfect adherence to protease inhibitors ranged from 31% to 54% depending on the measure used. There was little agreement between measures. Teenagers who reported perfect protease inhibitor adherence on both RSI-doses taken and DPD were approximately 5 times more likely to have a viral load less than 10,000 copies per milliliter. Advantages and disadvantages of each adherence method and clinical and research recommendations are discussed. 527

As treatment options have improved, there has been a significant increase in the life expectancy of HIV-infected children and adolescents. For most adolescents, the time comes when it is appropriate to transition from pediatric care to an adult or community-based provider. In response to a program closure, a transition readiness scale was developed. A total of 39 caregivers of HIV-infected youth (ages 10-18) and 12 youth over the age of 18 years were interviewed at two time points. Barriers associated with transition were identified and addressed between visits. Transition readiness improved and state anxiety decreased significantly from the first time point to the last visit (approximately 7 months later). Not having a home social worker was the most reported concern/need identified. Barriers to transition and interventions utilized to assist with transitioning care are discussed.

The purpose of this study was to compare and contrast three different methods for measuring self-reported antiretroviral medication adherence, correlate individual reports of adherence with measures of viral load, and identify the degree of concordance among self-reported medication adherence tools. Thirty-five adolescents between the ages of 11 and 21 years (mean age, 15.4) enrolled in National Cancer Institute (NCI) HIV primary treatment protocols participated in the study. Adherence approaches consisted of a clinical nurse rating (CNR), a Retrospective Self-Report Interview (RSI; using two different scoring criteria), and a 24-hour recall phone interview (Daily Phone Diary [DPD]). These were chosen because of their potential to be integrated within a clinical setting. Reported perfect adherence to protease inhibitors ranged from 31% to 54% depending on the measure used. There was little agreement between measures. Teenagers who reported perfect protease inhibitor adherence on both RSI-doses taken and DPD were approximately 5 times more likely to have a viral load less than 10,000 copies per milliliter. Advantages and disadvantages of each adherence method and clinical and research recommendations are discussed.