Association of Adolescent- and Caregiver-Reported Antiretroviral Therapy Adherence with HIV Viral Load Among Perinatally-infected South African Adolescents.

Journal: AIDS and behavior

Volume: 22

Issue: 3

Year of Publication: 2019

Affiliated Institutions:  Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa. kirsty.brittain@uct.ac.za. Department of Paediatrics & Child Health, University of Cape Town, Cape Town, South Africa. Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa. Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine, University of Cape Town, Cape Town, South Africa. Department of Paediatrics & Child Health, Tygerberg Academic Hospital & Stellenbosch University, Cape Town, South Africa. Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.

Abstract summary 

Accurate measurement of antiretroviral therapy (ART) adherence remains challenging and there are few data assessing the validity of self-reported adherence among perinatally HIV-infected adolescents. We examined adolescent and caregiver reports of adolescent adherence among perinatally-infected adolescents aged 9-14 years in Cape Town, South Africa, and explored factors that may modify associations between reported adherence and elevated viral load (VL). Among 474 adolescents (median age 12.0 years; median duration of ART use 7.5 years), elevated VL and caregiver- and adolescent-report of missed ART doses were common. Elevated VL was particularly prevalent among older, male adolescents. Low-moderate concordance was observed between caregiver and adolescent report. Among adolescents aged ≥ 12 years, caregiver- and adolescent-reported adherence was associated with elevated VL across most items assessed, but few significant associations were observed among adolescents < 12 years of age. Refined adherence measures and tools to identify adolescents who require adherence interventions are needed in this context.

Authors & Co-authors:  Brittain Kirsty K Asafu-Agyei Nana Akua NA Hoare Jacqueline J Bekker Linda-Gail LG Rabie Helena H Nuttall James J Roux Paul P Stein Dan J DJ Zar Heather J HJ Myer Landon L

Study Outcome 

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Citations :  Bernays S, Jarrett P, Kranzer K, Ferrand RA. Children growing up with HIV infection: the responsibility of success. Lancet. 2014;383(9925):1355–7.
Authors :  10
Identifiers
Doi : 10.1007/s10461-017-2004-2
SSN : 1573-3254
Study Population
Male
Mesh Terms
Adolescent
Other Terms
Adherence;Adolescent;HIV;Self-report;Viral load
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States