Paediatric ART Adherence in South Africa: A Comprehensive Analysis

Sabine L van Elsland; Remco P H Peters; Nelis Grobbelaar; Patiswa Ketelo; Maarten O Kok; Mark F Cotton; A Marceline van Furth

doi:10.1007/s10461-018-2235-x

Paediatric ART Adherence in South Africa: A Comprehensive Analysis

Sabine L van Elsland, Remco P H Peters, Nelis Grobbelaar, Patiswa Ketelo, Maarten O Kok, Mark F Cotton, A Marceline van Furth

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Abstract

Adherence to antiretroviral therapy (ART) remains a challenge for HIV-infected children. In this cross-sectional study, we used structured interview-administered questionnaires and medical records to measure adherence levels and factors associated with adherence and viral suppression. We included 195 South African children aged 2.1-12.9 on ART. Adherence levels ranged between 20.5% (pill count) and 89.1% (self-report). Boys were less adherent according to self-report, girls were less adherent according to pill count. Caregivers ensured medication was taken when the condition directly affected daily life. Well-functioning families and families with high SES provide a context supportive of adherence. Non-disclosure and difficulties administering medication negatively affected adherence and viral suppression. This study shows challenging levels of adherence impacting directly on viral suppression in a South African paediatric HIV program. Gender roles, non-disclosure and difficulty administering medication may undermine adherence and should be taken into account for clinical guidelines, policy design and inform strategies.

Original language	English
Pages (from-to)	475-488
Number of pages	14
Journal	AIDS and Behavior
Volume	23
Issue number	2
Early online date	27 Jul 2018
DOIs	https://doi.org/10.1007/s10461-018-2235-x
Publication status	Published - Feb 2019

Funding

The authors thank the study participants, the staff at the clinical site, TC Newman Hospital and Anova Health Institute and also Mrs. H. Lesch for her assistance with the data collection.

Funders	Funder number
Anova Health Institute
TC Newman Hospital

Keywords

Adolescent
Adult
Anti-HIV Agents/therapeutic use
CD4 Lymphocyte Count
Caregivers
Child
Child, Preschool
Cross-Sectional Studies
Disclosure
Female
HIV Infections/blood
Humans
Male
Medication Adherence/statistics & numerical data
Quality of Life
Sex Factors
Social Class
South Africa
Surveys and Questionnaires
Viral Load

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Paediatric ART Adherence in South Africa_A Comprehensive AnalysisFinal published version, 659 KBLicence: Article 25fa Dutch Copyright Act

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title = "Paediatric ART Adherence in South Africa: A Comprehensive Analysis",

abstract = "Adherence to antiretroviral therapy (ART) remains a challenge for HIV-infected children. In this cross-sectional study, we used structured interview-administered questionnaires and medical records to measure adherence levels and factors associated with adherence and viral suppression. We included 195 South African children aged 2.1-12.9 on ART. Adherence levels ranged between 20.5% (pill count) and 89.1% (self-report). Boys were less adherent according to self-report, girls were less adherent according to pill count. Caregivers ensured medication was taken when the condition directly affected daily life. Well-functioning families and families with high SES provide a context supportive of adherence. Non-disclosure and difficulties administering medication negatively affected adherence and viral suppression. This study shows challenging levels of adherence impacting directly on viral suppression in a South African paediatric HIV program. Gender roles, non-disclosure and difficulty administering medication may undermine adherence and should be taken into account for clinical guidelines, policy design and inform strategies.",

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author = "{van Elsland}, {Sabine L} and Peters, {Remco P H} and Nelis Grobbelaar and Patiswa Ketelo and Kok, {Maarten O} and Cotton, {Mark F} and {van Furth}, {A Marceline}",

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AU - Peters, Remco P H

AU - Grobbelaar, Nelis

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AU - Kok, Maarten O

AU - Cotton, Mark F

AU - van Furth, A Marceline

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AB - Adherence to antiretroviral therapy (ART) remains a challenge for HIV-infected children. In this cross-sectional study, we used structured interview-administered questionnaires and medical records to measure adherence levels and factors associated with adherence and viral suppression. We included 195 South African children aged 2.1-12.9 on ART. Adherence levels ranged between 20.5% (pill count) and 89.1% (self-report). Boys were less adherent according to self-report, girls were less adherent according to pill count. Caregivers ensured medication was taken when the condition directly affected daily life. Well-functioning families and families with high SES provide a context supportive of adherence. Non-disclosure and difficulties administering medication negatively affected adherence and viral suppression. This study shows challenging levels of adherence impacting directly on viral suppression in a South African paediatric HIV program. Gender roles, non-disclosure and difficulty administering medication may undermine adherence and should be taken into account for clinical guidelines, policy design and inform strategies.

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KW - Child, Preschool

KW - Cross-Sectional Studies

KW - Disclosure

KW - Female

KW - HIV Infections/blood

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KW - Male

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KW - Sex Factors

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JO - AIDS and Behavior

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ER -

Paediatric ART Adherence in South Africa: A Comprehensive Analysis

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