 |
|
Longitudinal Antiretroviral Adherence Among Adolescents Infected With Human Immunodeficiency Virus
Debra A. Murphy, PhD;
Marvin Belzer, MD;
Stephen J. Durako, BA;
Moussa Sarr, MD, MPH;
Craig M. Wilson, MD;
Larry R. Muenz, PhD; for the Adolescent Medicine HIV/AIDS Research Network
Arch Pediatr Adolesc Med. 2005;159:764-770.
Objectives To longitudinally follow a cohort of adolescents with human immunodeficiency virus (HIV) and to investigate long-term antiretroviral therapy adherence and factors associated with adherence.
Design, Setting, and Patients Adolescents infected with HIV (N = 231; mean age, 18.4 years; 72.7% female; 74.9% African American) from 13 cities throughout the United States were assessed at 3-month intervals.
Main Outcome Measures Self-reported adherence measures were validated by comparison with HIV-1 RNA viral load, and behavioral factors that may be associated with antiretroviral therapy adherence were assessed.
Results At the initial visit, approximately 69% of the adolescents reported being adherent to antiretroviral therapy. Adolescents in the later HIV disease stage were less likely to be adherent compared with those in the earlier disease stage. Less alcohol use and being in school were associated with adherence by adolescents on weekends and over the preceding month. Longitudinal adherence was investigated among 65 subjects initially adherent with available information for at least 4 consecutive visits. The median time to nonadherence was 12 months, and failure to maintain adherence was significantly associated with younger age and depression. Among adolescents who attained an undetectable viral load, only about 50% maintained an undetectable viral load for the year.
Conclusions These findings indicate an urgent need for better interventions to assist adolescents with HIV in adhering to their medication regimens. Adolescents with advanced disease are likely to need more intervention. New treatments recently found effective for adolescent depression may assist in improving adherence for a majority of adolescents with HIV.
Author Affiliations: Health Risk Reduction Projects, Department of Psychiatry, University of California, Los Angeles (Dr Murphy); Children’s Hospital of Los Angeles, Los Angeles, Calif (Dr Belzer); Westat Inc, Rockville, Md (Mr Durako and Drs Sarr and Muenz); and Department of Geographic Medicine, University of Alabama at Birmingham (Dr Wilson).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Predictors of Medication Adherence in High Risk Youth of Color Living with HIV
MacDonell et al.
J Pediatr Psychol 2009;0:jsp080v1-jsp080.
ABSTRACT
| FULL TEXT
Factors associated with lack of antiretroviral adherence among adolescents in a reference centre in Rio de Janeiro, Brazil
Filho et al.
Int J STD AIDS 2008;19:685-688.
ABSTRACT
| FULL TEXT
Brief Report: Maintenance of Effects of Motivational Enhancement Therapy to Improve Risk Behaviors and HIV-related Health in a Randomized Controlled Trial of Youth Living with HIV
Naar-King et al.
J Pediatr Psychol 2008;33:441-445.
ABSTRACT
| FULL TEXT
Clinical Outcomes After an Unstructured Treatment Interruption in Children and Adolescents With Perinatally Acquired HIV Infection
Saitoh et al.
Pediatrics 2008;121:e513-e521.
ABSTRACT
| FULL TEXT
Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management
Simoni et al.
Pediatrics 2007;119:e1371-e1383.
ABSTRACT
| FULL TEXT
Patient-related Factors Predicting HIV Medication Adherence among Men and Women with Alcohol Problems
Parsons et al.
J Health Psychol 2007;12:357-370.
ABSTRACT
Predictors of Adherence to Antiretroviral Medications in Children and Adolescents With HIV Infection
Williams et al.
Pediatrics 2006;118:e1745-e1757.
ABSTRACT
| FULL TEXT
|
