Barriers to Medication Adherence in HIV-Infected Children and Youth Based on Self- and Caregiver Report

Abstract

Lack of agreement was observed for more than half of the studied barriers, indicating discrepancies between children's and caregivers' perceptions of factors that influence medication-taking. The findings suggest a need for interventions that involve both child and caregiver in the tasks of remembering when to administer the child's medications, sustaining adherence, and appropriately transitioning medication responsibility to the youth.

The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities

“…[62][63][64] Among HIV-infected adolescents, barriers to adherence include medical, psychological, and logistical reasons. Medical barriers shown to affect adherence in youth include an AIDS diagnosis, 65 a difficult ART regimen, 65 absence of symptoms, 66 side effects of medication, 67 and dissatisfaction with the health team/system. 68 Logistical barriers such as forgetting medication doses, [65][66][67] travel, 66 and inconvenience/inconsistent routine 66,67 commonly affect adherence in youth.…”

“…Medical barriers shown to affect adherence in youth include an AIDS diagnosis, 65 a difficult ART regimen, 65 absence of symptoms, 66 side effects of medication, 67 and dissatisfaction with the health team/system. 68 Logistical barriers such as forgetting medication doses, [65][66][67] travel, 66 and inconvenience/inconsistent routine 66,67 commonly affect adherence in youth. Psychological barriers including depression/ anxiety, [69][70][71][72] perceived stigma, 69 lack of support, 72-74 behavioral and conduct problems 71 are present in more than 50% of HIV-infected youth.…”

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

“…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.…”

“…Studies have reported other adherence barriers, including feeling depressed or overwhelmed, fear of disclosure, sleeping through a dose, substance use, regimen complexity, not having medication, change in daily routine, and not wanting to be reminded of HIV infection. [12][13][14][15][16] However, the association between commonly reported adherence barriers and lack of virologic suppression, as well as the relative importance of barriers in predicting plasma HIV RNA, has not been examined. This information is critical in designing future interventions that are more likely to have a positive impact on HIV treatment goals.…”

Pharmacist-strengthen Adherence to Antiretroviral Therapy and the Contributing Factors among HIV-infected Paediatric Patients in Nigeria

“…Good clinical, immunological and virological outcomes from HAART rely on high rates of adherence to therapy 3 . These outcomes include reduction of HIV-related mortality and morbidity, restoring and/or preserving immune function, improving quality of life, maximally and durably suppressing viral replication, maintaining normal physical growth and tremendously improved the long-term survival of HIV-infected children 30 .…”