Correlates of Adherence to Antiretroviral Therapy in HIV-Infected Children in Lom,, Togo, West Africa
Correlates of Adherence to Antiretroviral Therapy in HIV-Infected Children in Lom,, Togo, West Africa
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DOI：
10.1007/s10461-008-9437-6
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发表时间：
2009-02-01
影响因子：
4.4
通讯作者：
Perez, Freddy
中科院分区：
文献类型：
--
作者：
Polisset, Julie;Ametonou, Francine;Perez, Freddy
我们评估了西非多哥儿童抗逆转录病毒治疗（ART）的依从性，并检查了相关因素。对在多哥洛梅的三个艾滋病毒/艾滋病护理中心连续登记接受抗逆转录病毒治疗的艾滋病毒感染儿童的护理人员进行了结构化访谈。儿童完全依从性反映了护理人员在过去4天和访谈前一个月内没有错过抗逆转录病毒药物剂量的报告。共纳入74名接受ART治疗的儿童（中位年龄6岁）。其中，42%的护理人员宣称完全遵守。在单变量分析中，与儿童不依从性相关的主要因素为：作为女性，生活在一个独立的环境中，（与扩大家族的化合物相比），接受其他ART而不是基于NNRT的方案，每天6片/匙或更多的药物方案，除生物父母以外的照顾者，未宣布HIV状态的照顾者，不参加支持团体，并认为抗逆转录病毒（ARV）管理有困难。在多变量分析中，女性，生活在一个单独的环境中，接受非非核苷类逆转录酶抑制剂为基础的方案和照顾者的ARV管理的感知困难仍然与报告的儿童的不遵守独立相关。这些数据显示，受儿童和照顾者特征的影响，西非儿童完全坚持抗逆转录病毒治疗的比例很低，这表明需要进行咨询和教育干预以及持续的心理和社会支持。
We assessed pediatric adherence to antiretroviral therapy (ART) and examined associated factors among children in Togo, West Africa. Structured interviews of caregivers of consecutively enrolled HIV-infected children receiving ART in three HIV/AIDS care centers in Lome, Togo were conducted. Child perfect adherence reflected caregivers' report of no antiretroviral drug doses missed neither in the past 4 days nor in the month before the interview. A total of 74 ART-treated children were included (median age 6 years). Of these, 42% of caregivers declared perfect adherence. In univariate analyses, the major factors relating to child non-adherence were: being female, living in an individual setting (vs. compound with enlarged family), receiving other ART than an NNRT-based regimen, drug regimens with six pills/spoons or more per day, caregiver other than biological parent, caregiver not declaring HIV-status, not participating to support groups and having perceived difficulty of antiretroviral (ARV) administration. In multivariate analysis, female gender, living in an individual setting, receiving other than NNRTI-based regimen and caregivers' perceived difficulty of ARV administration remained independently associated with the reported child's non-adherence. These data show low rates of perfect adherence to ART in children in West Africa, influenced by child and caregiver characteristics and suggest a need for counseling and education interventions as well as continuous psychological and social support.