Retention, adherence, and compliance: special needs of HIV-infected adolescent girls and young women

Dodds, Sally; Blakley, Theresa; Lizzotte, Jean Marie; Friedman, Lawrence B.; Shaw, Kimberly; Martinez, Jaime; Siciliano, Carl; Walker, Lynn E; Sotheran, Jo L.; Sell, Randall L.; Botwinick, Geri; Johnson, Robert L.; Bell, Douglas N.

doi:10.1016/s1054-139x(03)00157-5

Cited by 36 publications

(20 citation statements)

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“…Previous studies showed that the rates of high-risk sexual behaviour among HIV-infected adolescents and young adults were substantial [4][5][6][7][8][9][10]19]. In this study we found a striking lack of documentation of contraception use (40%; 27 of 67), past history of STIs (31%; 21 of 67) and date of the latest STI screen (46%; 31 of 67) in a significant proportion of patients.…”

Section: Pregnancy In Hiv-infected Teenagers 121mentioning

confidence: 45%

“…Studies of HIV-infected adolescents have noted a high prevalence of psychosocial problems, recreational drug use and sexual risk-taking behaviour as well as poor uptake of nonbarrier contraception and high rates of sexually transmitted infections (STIs) [3][4][5][6][7][8][9]. There is significant overlap between the social, demographic and behavioural determinants of teenage pregnancy and the characteristics of adolescents living with HIV [10].…”

Section: Introductionmentioning

confidence: 99%

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Pregnancy in HIV-infected teenagers in London

et al. 2010

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There were 67 pregnancies in 58 young women, of whom one was known to have acquired HIV vertically. The overall mother-to-child transmission (MTCT) rate of HIV was 1.5% (one of 66). There were 66 live births. Median ages at HIV diagnosis and conception were 17 and 18 years, respectively. Sixty-three per cent of women were diagnosed with HIV infection through routine antenatal screening. Eighty-two per cent of pregnancies (41 of 50) were unplanned, with 65% of women (26 of 40) using no contraception. Forty-three per cent of the women (20 of 46) had a past history of a sexually transmitted infection (STI). In 63 pregnancies, antiretroviral therapy was started postconception, with prevention of HIV MTCT the only indication in 81% of cases. Fifty-eight per cent of those on highly active antiretroviral therapy (HAART) had an undetectable HIV viral load by delivery. Eighty-seven per cent were uncomplicated pregnancies. Seventy-one per cent delivered by Caesarean section and 21% (14 of 64) had a preterm delivery (o37 weeks). In the 12 months after delivery, 45% of women received contraceptive advice and 25% of women became pregnant again. ConclusionObstetric and virological outcomes were favourable in this group of HIV-infected young women. However, the majority of pregnancies were unplanned with poor documentation of contraception use and advice and low rates of STI screening. A quarter of women conceived again within 12 months of delivery. Effective measures to reduce STIs, unplanned pregnancies and onward HIV transmission in HIV-infected teenagers are needed. Studies exploring pregnancy in HIV-infected adolescents are limited. The largest described 1183 live births in 1090 pregnant adolescents in the United States, the majority of whom had acquired HIV infection sexually [11]. Most pregnancies were unplanned (83%) and occurred in teenagers who had previously been pregnant (67%).A prospective cohort study of 638 vertically infected girls, again in the USA, reported 45 pregnancies, with 17% of girls experiencing a first pregnancy by their 19th birthday [8]. Of the 32 pregnancies resulting in live births, one infant was HIV-infected, 29 were uninfected and two had unknown infection status. Chibber and Khurranna also reported favourable obstetric outcomes and no cases of vertical transmission in a study of 30 pregnant vertically infected adolescents in India [12]. Other case series have described similar findings [13][14][15]. In a small European study, there were nine live births with no mother-to-child transmissions [16]. To date there have been no studies in the UK looking at pregnancy in teenagers living with HIV.In this study we reviewed the pregnancies of 58 HIVinfected teenagers attending for care at 12 London hospitals. We explore the medical and social features of this group and describe their sexual and reproductive health issues, their response to antiretroviral therapy (ART) and pregnancy outcome. MethodsWe conducted a retrospective case note review of HIVinfected pregnant female patients aged between 13 and...

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Section: Pregnancy In Hiv-infected Teenagers 121mentioning

confidence: 45%

Section: Introductionmentioning

confidence: 99%

Pregnancy in HIV-infected teenagers in London

et al. 2010

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“…43,68 On the basis of work with adolescents and young adults, Dodds et al 73 cited the benefits of adopting a developmental framework, fostering buddy systems, and determining psychological and psychosocial treatment readiness. They stressed the need for intensive, continuous, coordinated, and nurturing case management services, with screening and treatment for mental health problems and substance abuse.…”

Section: Recommendations For Improving Adherencementioning

confidence: 99%

Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management

Simoni

Montgomery

Martin³

et al. 2007

Pediatrics

197

166

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Although nonadherence to prescribed therapies is widespread, it is particularly problematic with highly active antiretroviral therapy for HIV infection. This review of >50 studies in the area of pediatric HIV infection revealed varying methods for assessing antiretroviral adherence with a wide range of estimates of adherence. Correlates of adherence could be grouped as those relating to the medication, the patient, and the caregiver/family, with many conflicting findings and a lack of theory guiding the research. Only 8 studies, mainly small feasibility or pilot investigations, evaluated highly active antiretroviral therapy adherence interventions in pediatric populations. We conclude with specific recommendations for assessment and clinical management of adherence and discuss directions for future research in this area. KeywordsHIV/AIDS; adherence; compliance; interventions; pediatric Adherence to therapy, or the extent to which a patient's behaviors coincide with medical advice mutually negotiated between the health professional and the patient, is a universal HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript challenge with all illnesses and in all age groups. 1 Each year in the United States, 500 000 physicians write 1.8 billion prescriptions involving 55 000 pharmacies. 2 However, many of these prescribed medications are never taken, with rates of nonadherence ranging from 15% to 93%. 3 Among persons with chronic illnesses, nonadherence is especially problematic, occurring in up to 82% of cases. [4][5][6] The effects of nonadherence range from individual disability (eg, unrelieved pain) to global threat (eg, development of treatment-resistant bacteria or viruses). The yearly monetary costs of nonadherence exceed $100 billion. 7Adherence is particularly critical with highly active antiretroviral therapy (HAART) in the treatment of pediatric HIV infection. The data on HAART for pediatric HIV infection, although scarcer than for adults, suggest that medication adherence is a strong predictor of therapeutic impact. 8,9 For example, Wiener et al 10 observed that among children with an HIV-1 RNA viral load (VL) < 10 000, 75% had taken 100% of their medication doses in the previous week, whereas among those with a VL of ≥10 000, only 36% reported taking all of their medication.Despite the benefits of HAART in treating pediatric HIV infection [11][12][13][14][15] and the adverse consequences of nonadherence, adherence is reportedly suboptimal among children. [16][17][18][19][20] It is likely thwarted by multiple barriers 21,22 and complicated because, unlike with many other chronic illnesses, most children who are born with HIV in the United States are ethnic/racial minorities who live in chronic poverty with limited resources and face discrimination, family disruption, substance abuse, and the stressors of life in the inner city. 23 In addition, stigma is greater for HIV/AIDS than other chronic illnesses, which often leads caregivers to conceal the child's diagnosis a...

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“…Disclosure to individuals within one's social network can lead to improved behavior and health outcomes, such as adherence, 1,2 and may lead to improvements in mental well-being. 3 Disclosure to sexual partners facilitates communication and informed decision making about sexual behaviors and risks.…”

mentioning

confidence: 99%

Depression and HIV Serostatus Disclosure to Sexual Partners Among Newly HIV-Diagnosed Men Who Have Sex with Men

Abler

Sikkema

Watt

et al. 2015

AIDS Patient Care and STDs

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HIV disclosure to sexual partners facilitates joint decision-making and risk reduction strategies for safer sex behaviors, but disclosure may be impacted by depression symptoms. Disclosure is also associated with disclosure self-efficacy, which in turn may also be influenced by depressive symptoms. This study examined the relationship between depression and HIV disclosure to partners following diagnosis among men who have sex with men (MSM), mediated by disclosure self-efficacy. Newly HIV-diagnosed MSM (n = 92) who reported sexual activity after diagnosis completed an assessment soon after diagnosis which measured depressive symptoms, and another assessment within 3 months of diagnosis that measured disclosure self-efficacy and disclosure. Over one-third of the sample reported elevated depressive symptoms soon after diagnosis and equal proportions (one-third each) disclosed to none, some, or all partners in the 3 months after diagnosis. Depressive symptoms were negatively associated with disclosure self-efficacy and disclosure to partners, while disclosure self-efficacy was positively associated with disclosure. Disclosure self-efficacy partially mediated the relationship between depression and disclosure, accounting for 33% of the total effect. These findings highlight the importance of addressing depression that follows diagnosis to enhance subsequent disclosure to sexual partners.

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Retention, adherence, and compliance: special needs of HIV-infected adolescent girls and young women

Cited by 36 publications

References 1 publication

Pregnancy in HIV-infected teenagers in London

Pregnancy in HIV-infected teenagers in London

Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management

Depression and HIV Serostatus Disclosure to Sexual Partners Among Newly HIV-Diagnosed Men Who Have Sex with Men

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