Predictors of adherence to antiretroviral treatment and therapeutic success among children in South Africa.
Identifieur interne : 001382 ( PubMed/Checkpoint ); précédent : 001381; suivant : 001383Predictors of adherence to antiretroviral treatment and therapeutic success among children in South Africa.
Auteurs : Alexandra D. Muller [Allemagne] ; Stefan Bode ; Landon Myer ; Jutta Stahl ; Nicole Von SteinbuchelSource :
- AIDS care [ 1360-0451 ] ; 2011.
Descripteurs français
- KwdFr :
- Aidants, Antirétroviraux (usage thérapeutique), Attitude envers la santé, Charge virale, Connaissances, attitudes et pratiques en santé, Divulgation, Enfant, Enfant d'âge préscolaire, Enquêtes et questionnaires, Facteurs socioéconomiques, Femelle, Humains, Infections à VIH (traitement médicamenteux), Mâle, Observance du traitement médicamenteux (psychologie), Qualité de vie, République d'Afrique du Sud, Résultat thérapeutique, Stigmate social, Études transversales.
- MESH :
- psychologie : Observance du traitement médicamenteux.
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Antirétroviraux.
- Aidants, Attitude envers la santé, Charge virale, Connaissances, attitudes et pratiques en santé, Divulgation, Enfant, Enfant d'âge préscolaire, Enquêtes et questionnaires, Facteurs socioéconomiques, Femelle, Humains, Mâle, Qualité de vie, République d'Afrique du Sud, Résultat thérapeutique, Stigmate social, Études transversales.
- Wicri :
- geographic : Afrique du Sud.
English descriptors
- KwdEn :
- Anti-Retroviral Agents (therapeutic use), Attitude to Health, Caregivers, Child, Child, Preschool, Cross-Sectional Studies, Disclosure, Female, HIV Infections (drug therapy), Health Knowledge, Attitudes, Practice, Humans, Male, Medication Adherence (psychology), Quality of Life, Social Stigma, Socioeconomic Factors, South Africa, Surveys and Questionnaires, Treatment Outcome, Viral Load.
- MESH :
- chemical , therapeutic use : Anti-Retroviral Agents.
- geographic : South Africa.
- drug therapy : HIV Infections.
- psychology : Medication Adherence.
- Attitude to Health, Caregivers, Child, Child, Preschool, Cross-Sectional Studies, Disclosure, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Quality of Life, Social Stigma, Socioeconomic Factors, Surveys and Questionnaires, Treatment Outcome, Viral Load.
Abstract
The recent years have shown an up-scaling of treatment programs for HIV-infected children in resource-limited settings, with an increased focus on adherence. Little is known, however, about the influence of socioeconomic as well as caregivers' health beliefs on both adherence and virologic outcome of pediatric antiretroviral treatment in these settings. We conducted a cross-sectional study with 57 caregiver-child dyads at a public hospital in Cape Town, South Africa. Adherence was electronically monitored over three months, viral loads were available pre- and post-study. Caregivers answered questionnaires on their socioeconomic situation, attitudes toward and knowledge about treatment, and quality of life. Young children with a mean age of 51 months (SD 25.6) were investigated, and all were cared for by female caregivers. Mean adherence was 81%, and 67% of children achieved virologic suppression (VS). Household income, educational status, and child characteristics were not significantly correlated with adherence. Disclosure of both the child's and the caregiver's HIV status was linked to achieving VS and was a significant predictor for VS. A model including child's health status, caregiver's language skills, caregiver's disclosure, and perceived stigmatization could explain 95% of the variance in VS. Adherence and VS were not associated with socioeconomic factors in this population. Social factors such as stigmatization, fear of disclosure, and caregivers' attitudes toward the health-care system influenced VS but not adherence.
DOI: 10.1080/09540121003758523
PubMed: 20645192
Affiliations:
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pubmed:20645192Le document en format XML
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<front><div type="abstract" xml:lang="en">The recent years have shown an up-scaling of treatment programs for HIV-infected children in resource-limited settings, with an increased focus on adherence. Little is known, however, about the influence of socioeconomic as well as caregivers' health beliefs on both adherence and virologic outcome of pediatric antiretroviral treatment in these settings. We conducted a cross-sectional study with 57 caregiver-child dyads at a public hospital in Cape Town, South Africa. Adherence was electronically monitored over three months, viral loads were available pre- and post-study. Caregivers answered questionnaires on their socioeconomic situation, attitudes toward and knowledge about treatment, and quality of life. Young children with a mean age of 51 months (SD 25.6) were investigated, and all were cared for by female caregivers. Mean adherence was 81%, and 67% of children achieved virologic suppression (VS). Household income, educational status, and child characteristics were not significantly correlated with adherence. Disclosure of both the child's and the caregiver's HIV status was linked to achieving VS and was a significant predictor for VS. A model including child's health status, caregiver's language skills, caregiver's disclosure, and perceived stigmatization could explain 95% of the variance in VS. Adherence and VS were not associated with socioeconomic factors in this population. Social factors such as stigmatization, fear of disclosure, and caregivers' attitudes toward the health-care system influenced VS but not adherence.</div>
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