Pediatric Human Immunodeficiency Virus Continuum of Care

Gray, Mary C.; Nieburg, Phillip; Dillingham, Rebecca

doi:10.1016/j.pcl.2017.03.009

Cited by 7 publications

(5 citation statements)

References 32 publications

(48 reference statements)

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“…Other factors, such as medication formulation, frequency of dosing, drug toxicities and their side effects, developmental stage as well as psycho-social, behavioral, and socio-demographic characteristics of adolescents, have been associated with non-adherence to ART. However, no consistent predictors of either good or poor adherence in adolescents have been identified [39][40][41], thereby posing a threat to adolescents' adherence during crisis, such as the COVID-19 pandemic. Several studies have demonstrated that adherence is not static, and can fluctuate with time on treatment [42].…”

Section: Other Challenges Of Art Adherencementioning

confidence: 99%

Adherence to anti-retroviral therapy during COVID-19 pandemic among adolescents born HIV-positive

Muchena¹,

Kalenga²

2021

HIV & AIDS Review

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Successful rollout of anti-retroviral therapy (ART) in Africa has resulted in a steep decline in HIV incidence. Even though this has been a long-awaited development, it is not the case for adolescents (10-19 years) born HIV-positive. Given this brief background and dangers imposed by COVID-19 pandemic, adolescents born HIV-positive are at great risk. A systematic review was conducted and reported, according to preferred reporting items for meta-analyses (PRISMA). Studies were drawn from database search performed between April and June 2020 using PsycINFO, Google Scholar, and Sabinet. Results suggested that factors, which negatively impact ART adherence fall into three main levels: 1. Household level: through pressure to share medication; 2. Institutional level: lockdown restrictions due to COVID-19, long distance to facilities, heavy workload due to limited staff, and extended waiting times; 3. Community level: structural barriers, such as HIV stigma and discrimination, gender inequalities, and poor living conditions. Main motivators to remain adherent to ART include having a strong social support system, life goals, and ambitions. This paper highlights the complexity of ART adherence during COVID-19 pandemic. Interventions to improve adherence to ART of adolescents born HIV-positive should address psycho-social factors, such as treatment fatigue, disclosure and family, and household dynamics, in addition to access to ART service delivery during periods of crisis.

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Section: Other Challenges Of Art Adherencementioning

confidence: 99%

Adherence to anti-retroviral therapy during COVID-19 pandemic among adolescents born HIV-positive

Muchena¹,

Kalenga²

2021

HIV & AIDS Review

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“…Progress towards elimination of pediatric HIV and planning of health services and provision of ART in many high burden countries is hampered by the lack of resources to report robust age-specific data [3]. Past estimates of rates of MTCT and numbers of CWH have been generated from health facility data and mathematically modeled projections [4,5].…”

Section: Introductionmentioning

confidence: 99%

The state of the pediatric HIV epidemic in Lesotho

Frederix

Schwitters

Chung

et al. 2023

Aids

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Objective: Lesotho does not have reliable data on HIV prevalence in children, relying on estimates generated from program data. The 2016 Lesotho Population-based HIV Impact Assessment (LePHIA) aimed to determine HIV prevalence among children 0–14 years to assess the effectiveness of the prevention of mother-to-child transmission (PMTCT) program and guide future policy. Methods: A nationally representative sample of children under 15 years underwent household-based, two-stage HIV testing from November 2016-May 2017. Children <18 months with a reactive screening test were tested for HIV infection using total nucleic acid (TNA) PCR. Parents (61.1%) or legal guardians (38.9%) provided information on children's clinical history. Children aged 10–14 years also answered a questionnaire on knowledge and behaviors. Results: HIV prevalence was 2.1% [95% confidence interval (CI): 1.5–2.6]. Prevalence in 10–14 year olds (3.2%; 95% CI: 2.1, 4.2) was significantly greater compared to 0–4 year olds (1.0%; 95% CI: 0.5, 1.6). HIV prevalence in girls and boys was 2.6% (95% CI: 1.8–3.3) and 1.5% (95% CI: 1.0–2.1), respectively. Based on reported status and/or the presence of detectable antiretrovirals, 81.1% (95% CI: 71.7–90.4) of HIV-positive children were aware of their status, 98.2% (95% CI: 90.7–100.0) of those aware were on antiretroviral therapy (ART) and 73.9% (95% CI: 62.1–85.8) of those on ART were virally suppressed. Conclusions: Despite the roll-out of Option B+ in Lesotho in 2013, pediatric HIV prevalence remains high. Further research is required to understand the greater prevalence among girls, barriers to PMTCT, and how to better achieve viral suppression in children with HIV.

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“…death of parents due to AIDS, suicide risk; Dako-Gyeke et al, 2020; Lall et al, 2015) and mental health problems like depression and anxiety (Dessauvagie et al, 2020; Too et al, 2021). Previous research has found a bidirectional association between depression and ART adherence (Benton et al, 2019) and a relationship between anxiety and notification of diagnosis, which in turn involves stigma and fear of rejection (Chandwani et al, 2012; Gray et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Social and mental health characteristics of adolescents living with HIV in Mexico: Implications for adherence to antiretroviral treatment

Arroyo-Jiménez,

Benjet,

Robles

et al. 2023

J Health Psychol

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Mexico is the third Latin American country with the most children and adolescents living with human immunodeficiency virus (ALHIV). There is a lack of information on the characteristics of this population. We aimed to describe the social and mental health characteristics of Mexican ALHIV. A census was conducted of all adolescent patients with HIV at a pediatric hospital ( n = 47; mean age 14.39, S.D. = 3.65) and their caregivers. We collected data on socio-demographic characteristics, family, intelligence, mental health, adverse life events, substance use, treatment, knowledge of Antiretroviral Treatment (ART) and HIV, and biomarkers. Most cases were transmitted vertically and self-reported ART adherence was above 90%. Some obstacles to adherence were medicine discomfort, believing that they did not need it, and forgetfulness. The vulnerabilities were intellectual disability, adverse life events, possible mental health problems, and little knowledge of their illness and treatment. These findings suggest the importance of interventions to improve the perception and knowledge of HIV and ART to increase ART adherence.

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Pediatric Human Immunodeficiency Virus Continuum of Care

Cited by 7 publications

References 32 publications

Adherence to anti-retroviral therapy during COVID-19 pandemic among adolescents born HIV-positive

Adherence to anti-retroviral therapy during COVID-19 pandemic among adolescents born HIV-positive

The state of the pediatric HIV epidemic in Lesotho

Social and mental health characteristics of adolescents living with HIV in Mexico: Implications for adherence to antiretroviral treatment

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