Barriers to HAART Adherence Among Human Immunodeficiency Virus–Infected Adolescents

Abstract

Adherence was tied closely with daily routine, which supports the assumption that working closely with adolescents to improve their organizational skills may be necessary to improve adherence. Patient-level intervention, provider-level intervention, and health care system modification may all be necessary to improve HIV-infected adolescents' adherence to HAART.

Virologic Response Using Directly Observed Therapy in Adolescents With HIV: An Adherence Tool

“…Adherence to medication regimens is a significant barrier in the care of children and adolescents with HIV (Matsui, 1997;Murphy et al, 2003;Wiener, Riekert, Ryder & Wood, 2004). In a cohort of 114 adolescents, viral load was significantly correlated with medication adherence self-report (Murphy et al, 2003).…”

“…In a study by Van Dyke et al, 2002, almost one-third of 125 HIVinfected pediatric subjects, most of whom were not adolescents, reported non-adherence to ARVs over the course of one year. Only 41% of a group of 161 HIV-positive adolescents infected via sexual contact or drug injection reported full ARV adherence (Murphy et al, 2003).Although adolescents with behaviorally acquired infection are clearly a different cohort in terms of HIV-disease state and ARV experience, they share the same developmental stage as adolescents with vertically-acquired infection. Adolescents with vertically-acquired HIV often have received multiple regimens in the past and have virus with significant resistance to most ARVs, frequently leading to more complex ARV regimens with a greater pill burden, and thus a greater incidence of nonadherence.…”

“…In the adolescent population, psychosocial factors contribute greatly to non-adherence to antiretrovirals (ARVs), and often adolescents are given independence in taking medications despite not fully understanding their regimens (Martin, Elliot, Toledo-Tamula, Wolters, & Wood, 2004;Murphy et al, 2003). However, data on adherence to ARVs in vertically-infected adolescents are limited.…”

“…In a study by Van Dyke et al, 2002, almost one-third of 125 HIVinfected pediatric subjects, most of whom were not adolescents, reported non-adherence to ARVs over the course of one year. Only 41% of a group of 161 HIV-positive adolescents infected via sexual contact or drug injection reported full ARV adherence (Murphy et al, 2003).…”

Terapia anti-retroviral: fatores que interferem na adesão de crianças com HIV/AIDS

“…Conforme demonstrado por estudos, falhas na adesão aumentam o risco de incompleta supressão viral e de desenvolvimento de cepas virais resistentes aos medicamentos disponíveis 16,17 . Diante de situações difíceis de lidar relativas ao tratamento e a aspectos do cotidiano, os cuidadores primários -muitos deles também soropositivosadotam estratégias de enfrentamento diversas, com vistas ao bem-estar físico, psicológico e social das crianças 18 .…”