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Excellent Adherence to Antiretrovirals in HIV+ Zambian Children Is Compromised by Disrupted Routine, HIV Nondisclosure, and Paradoxical Income Effects

Author

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  • Jessica E Haberer
  • Adrian Cook
  • A Sarah Walker
  • Marjorie Ngambi
  • Alex Ferrier
  • Veronica Mulenga
  • Cissy Kityo
  • Margaret Thomason
  • Desiree Kabamba
  • Chifumbe Chintu
  • Diana M Gibb
  • David R Bangsberg

Abstract

Introduction: A better understanding of pediatric antiretroviral therapy (ART) adherence in sub-Saharan Africa is necessary to develop interventions to sustain high levels of adherence. Methodology/Principal Findings: Adherence among 96 HIV-infected Zambian children (median age 6, interquartile range [IQR] 2,9) initiating fixed-dose combination ART was measured prospectively (median 23 months; IQR 20,26) with caregiver report, clinic and unannounced home-based pill counts, and medication event monitoring systems (MEMS). HIV-1 RNA was determined at 48 weeks. Child and caregiver characteristics, socio-demographic status, and treatment-related factors were assessed as predictors of adherence. Median adherence was 97.4% (IQR 96.1,98.4%) by visual analog scale, 94.8% (IQR 86,100%) by caregiver-reported last missed dose, 96.9% (IQR 94.5,98.2%) by clinic pill count, 93.4% (IQR 90.2,96.7%) by unannounced home-based pill count, and 94.8% (IQR 87.8,97.7%) by MEMS. At 48 weeks, 72.6% of children had HIV-1 RNA

Suggested Citation

  • Jessica E Haberer & Adrian Cook & A Sarah Walker & Marjorie Ngambi & Alex Ferrier & Veronica Mulenga & Cissy Kityo & Margaret Thomason & Desiree Kabamba & Chifumbe Chintu & Diana M Gibb & David R Bang, 2011. "Excellent Adherence to Antiretrovirals in HIV+ Zambian Children Is Compromised by Disrupted Routine, HIV Nondisclosure, and Paradoxical Income Effects," PLOS ONE, Public Library of Science, vol. 6(4), pages 1-8, April.
    • Handle: RePEc:plo:pone00:0018505
    DOI: 10.1371/journal.pone.0018505
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    References listed on IDEAS

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    1. Norma C Ware & John Idoko & Sylvia Kaaya & Irene Andia Biraro & Monique A Wyatt & Oche Agbaji & Guerino Chalamilla & David R Bangsberg, 2009. "Explaining Adherence Success in Sub-Saharan Africa: An Ethnographic Study," PLOS Medicine, Public Library of Science, vol. 6(1), pages 1-7, January.
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    Cited by:

    1. Emeka Francis Okonji & Brian van Wyk & Gail D. Hughes & Ferdinand C. Mukumbang, 2022. "Psychosocial Support Programme Improves Adherence and Health Systems Experiences for Adolescents on Antiretroviral Therapy in Mpumalanga Province, South Africa," IJERPH, MDPI, vol. 19(23), pages 1-24, November.
    2. Pierre Zalagile Akilimali & Patou Masika Musumari & Espérance Kashala-Abotnes & Patrick Kalambayi Kayembe & François B Lepira & Paulin Beya Mutombo & Thorkild Tylleskar & Mapatano Mala Ali, 2017. "Disclosure of HIV status and its impact on the loss in the follow-up of HIV-infected patients on potent anti-retroviral therapy programs in a (post-) conflict setting: A retrospective cohort study fro," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-13, February.

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