Disclosure of HIV status and adherence to daily drug regimens among HIV-infected children in Uganda
Disclosure of HIV status and adherence to daily drug regimens among HIV-infected children in Uganda
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DOI：
10.1007/s10461-006-9141-3
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发表时间：
2006-07-01
影响因子：
4.4
通讯作者：
Bunnell, Rebecca
中科院分区：
文献类型：
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作者：
Bikaako-Kajura, Winnie;Luyirika, Emmanuel;Bunnell, Rebecca
在大多数艾滋病毒感染儿童居住的非洲，尚未广泛评估儿童对每日药物治疗方案的依从性。在乌干达的一家综合性艾滋病毒/艾滋病诊所，我们对42名接受抗逆转录病毒治疗和/或复方新诺明预防治疗的艾滋病毒感染儿童和42名主要照顾者进行了深入访谈，评估了他们的依从性经验，以改进方案。儿科诊所提供的每日药物方案包括复方新诺明预防以及ART和复方新诺明联合治疗。照顾者向儿童完全披露艾滋病毒状况和强有力的父母关系与良好的依从性有关。结构性因素，包括贫困和耻辱，是阻碍遵守的障碍，即使是那些完全披露和与父母的支持关系的儿童。为了确保坚持使用延长生命的药物，我们的研究结果强调，提供者需要支持照顾者披露，提供持续的支持，并与服用复方新诺明预防和ART的艾滋病毒感染儿童保持开放的沟通。
Pediatric adherence to daily drug regimens has not been widely assessed in Africa where majority of HIV infected children live. Using in-depth interviews of 42 HIV-infected children taking ART and/or cotrimoxazole prophylaxis, and 42 primary caregivers, at a comprehensive HIV/AIDS clinic in Uganda, we evaluated their adherence experiences for purposes of program improvement. Daily drug regimens provided by the pediatric clinic included cotrimoxazole prophylaxis as well as ART and cotrimoxazole combined. Complete disclosure of HIV status by caregivers to children and strong parental relationships were related to good adherence. Structural factors including poverty and stigma were barriers to adherence even for children who had had complete disclosure and a supportive relationship with a parent. To ensure adherence to life-extending medications, our findings underscore the need for providers to support caregivers to disclose, provide on-going support and maintain open communication with HIV-infected children taking cotrimoxazole prophylaxis and ART.