Barriers to Medication Adherence in Behaviorally and Perinatally Infected Youth Living with HIV

Abstract

The study explored barriers to antiretroviral medication adherence in perinatally and behaviorally HIV infected adolescents and young adults in a cross-sectional, multisite sample. The study included a subset of a convenience sample from a cross-sectional analysis. Participants were youth with HIV ages 12–24 who were prescribed HIV medication and reported missing medication in the past 7 days (n = 484, 28.4 % of protocol sample). The top barriers were similar for perinatally and behaviorally infected youth, but perinatally infected youth reported significantly more barriers. Forgetting, not feeling like taking medication and not wanting to be reminded of HIV infection were the most common barriers reported. Number of barriers was significantly correlated with percent of doses missed, viral load, and psychological distress for perinatally infected youth and with doses missed, psychological distress, and substance use for behaviorally infected youth. Interventions to improve adherence to HIV medications should not only address forgetfulness and choosing not to take medications, but also consider route of infection.

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

“…Although there are some data on the barriers to and predictors of adherence 92, there are few studies of successful interventions to improve it 93, 94, and there is no gold standard for measuring it. Adherence can be influenced by many factors, including those related to the child/young person (e.g.…”

Barriers to Antiretroviral Therapy Adherence and Plasma HIV RNA Suppression Among AIDS Clinical Trials Group Study Participants

“…[1][2][3][4][5][6][7] Despite the ability to attain virologic suppression with adherence rates as low as 70-80%, depending on the ART regimen, [8][9][10] ART adherence in North America has been estimated to be as low as 55% 11 and lower mean ART adherence levels of 33-50% have been reported in the US. 12,13 Therefore, it is imperative to understand barriers to adherence and to examine the association between these barriers and HIV treatment goals in order to develop effective ART adherence interventions.…”

“…For example, given that forgetting to take ART has been reported to be one of the most commonly stated adherence barriers, [12][13][14][15][16] many studies have examined the use of reminder devices in improving adherence. [17][18][19][20] However, most have not revealed clinically significant changes in adherence.…”

Acceptability and Feasibility of a Cell Phone Support Intervention for Youth Living with HIV with Nonadherence to Antiretroviral Therapy

“…[4][5][6] When researchers directly ask youth living with HIV why they missed taking their medication, the most common answers are, ''I forgot,'' ''I didn't have my medications with me,'' or ''I had a change in my daily routine.'' 7 Other potential factors that may play a role in youth adherence include stigma and decisional capacity. 8,9 There have been several studies of modestly successful intervention approaches for youth living with HIV who had poor medication adherence including motivational interviewing, 10 directly observed therapy, 11 personalized text message reminders, 12 and cell phone call reminders.…”