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AIDS Patient Care STDS. 2011 Mar;25(3):191-200. doi: 10.1089/apc.2010.0181. Epub 2011 Feb 16.

Medication adherence in children and adolescents with HIV infection: associations with behavioral impairment.

Collaborators (300)

Culnane M, Hawkins E, Mofenson L, Bryson YJ, Connor EM, D'Angelo L, Mintz M, O'Donnell KJ, Oxtoby M, Hale AR, Gelber RD, Gortmaker S, Lenderking W, Marrow L, Joy C, Clark C, Cunningham B, Sperling R, Scott GB, Fletcher C, Caldwell B, Donovan D, Smith E, Fresia A, Ciupak G, Elgie C, Eagle M, Smith DR, Palumbo P, Sleasman J, Connor J, Hughes M, Oyomopita R, Johnson G, Wiznia A, Hutton N, Kovacs A, Sawyer M, Anderson M, Rogers A, Borkowsky W, Lindsey J, Moye J, Levin M, Crain M, Britto P, Toumala R, Cervia J, Monagham E, Dominguez K, Higgins M, Seage G, Gaughan D, Gona P, Shearer W, Howland L, Storm D, Malee K, Mitchell W, Gore C, Powell E, McConnell M, Beatty N, Brogly S, Bryant J, Chernoff M, Heckman B, English D, Handelsman E, Jean-Philippe P, Kaiser K, Kraimer J, Millar L, Traite S, Williams P, Woods E, Worrell C, Minglana F, Paul ME, Jackson CD, Rathore MH, Khayat A, Champion K, Cusic S, Yogev R, Chadwick E, Febo-Rodriguez I, Nieves S, Purswani M, Baksi S, Stuard E, Dummit M, Acevedo M, Gonzalez M, Fabregas L, Texidor ME, Scott GB, Mitchell CD, Taybo L, Willumsen S, Bettica L, Amour J, Dashefsky B, Oleske J, Silio M, Alchediak T, Borne C, Cowie M, Spector SA, Viani R, Caffery M, Proctor L, Rana S, Darbari D, Roa JC, Yu PH, Donovan M, Serrano R, Burey M, Auguste R, Chen J, Foster J, Stechenberg BW, Fisher DJ, Johnston AM, Toye M, Homans J, Neely M, Spencer LS, Kovacs A, Burchett S, Karthas N, Moore E, Cromer C, Flynn PM, Patel N, Donohoe M, Jones S, Borkowsky W, Chandwani S, Deygoo N, Akleh S, Handelsman E, Moallem HJ, Swindell DM, Kaye JM, Higgins A, Foca M, LaRussa P, Gershon A, Rutstein RM, Vincent CA, Douglas SD, Koutsoubis GA, Petru A, Courville T, Wara D, Trevithick D, McFarland E, Salbenblatt C, Hutton N, Griffith B, Joyner M, Kiefner C, Acker M, Croteau R, McLellan C, Mohan K, Bamji M, Pathak I, Manwani S, Patel E, Spiegel H, Amos V, Luzuriaga K, Pass R, Crain M, Farley J, Klipner K, Bonagura VR, Schuval SJ, Colter C, Campbell L, Pelton SI, Reagan AM, Rich KC, Hayani K, Bicchinella M, Nachman S, Ferraro D, Madjar S, Puga A, Wiley F, Whitfield K, Johnson O, Dizney R, Champion S, Frere M, DiGrado M, Abrams EJ, Martinez J, Mancao M, Salazar J, Karas G, Belho T, Pitkin B, Eddleman J, Figueroa W, Reyes E, Weiner LB, Contello KA, Holz WA, Famiglietti MJ, Lawrence R, Lew J, Delany C, Duff C, Fernandez AD, Hughes PA, Wade N, Adams ME, Piatt JP, Foti J, Clarke-Steffen L, Sleasman J, Delaney C, Mani CS, Andiman WA, Romano S, Hurst L, de Jesus J, Wilson G, Weinberg GA, Gigliotti F, Murante B, Laverty S, Hutchcon N, Townley A, Nesheim S, Dennis R, Emmanuel P, Lujan-Zilberman J, Graisberry C, Moore S, Fisher RG, Cunnion KM, Rubio TT, Sandifer D, Johnson GM, Gay H, Sadler S, Keller M, Hayes J, Gagajena A, Mink C, Johnson D, Church J, Dunaway T, Salata C, Deveikis A, Melton L, Gaur S, Whitley-Williams P, Malhotra A, Cerracchio L, Dolan M, D'Agostino J, Posada R, Mani C, Cobb S, Lavoie SR, Smith TY, Feingold A, Burrows-Clark S, Mrus J, Beiting R, Brady M, Hunkler J, Koranyi K, Albritton W, Warford R, Arpadi S, Gershon A, Miller P, Rubinstein A, Krienik G, Kovacs A, Operskalski E, Wara D, Kamrin A, Farrales S, Johan-Liang R, O'Keefe K, McGann KA, Pickering L, Storch GA, Pahwa S, Rodriquez L, Lewis P, Croteau R.

Author information

  • 1Department of Child and Adolescent Psychiatry, Children's Memorial Hospital, Chicago, Illinois 60614, USA. kmalee@childrensmemorial.org

Abstract

The impact of behavioral functioning on medication adherence in children with perinatally acquired HIV infection is not well-explored, but has important implications for intervention. This report addresses the relationship between behavioral functioning and child self-report or caregiver report of medication adherence among children and adolescents enrolled in Pediatric AIDS Clinical Trials Group Protocol 219C (conducted 2000-2007). A total of 1134 participants, aged 3-17 years, received a behavioral evaluation and adherence assessment. Complete adherence was defined as taking 100% of prescribed antiretroviral medications during three days preceding the study visit. Multivariable logistic regression models were used to evaluate associations between adherence and behavioral functioning, adjusting for potential confounders, including demographic, psychosocial, and health factors. Children demonstrated higher than expected rates of behavioral impairment (≈7% expected with T > 65) in the areas of conduct problems (14%, z = 7.0, p < 0.001), learning problems (22%, z = 12.2, p < 0.001), somatic complaints (22%, z = 12.6, p < 0.001), impulsivity-hyperactivity (20%, z = 11.1, p < 0.001), and hyperactivity (19%, z = 10.6, p < 0.001). Children with behavioral impairment in one or more areas had significantly increased odds of nonadherence [adjusted odds ratio (aOR) = 1.49, p = 0.04]. The odds of nonadherence were significantly higher for those with conduct problems and general hyperactivity (aOR = 2.03, p = 0.005 and aOR = 1.68, p = 0.02, respectively). Psychosocial and health factors, such as recent stressful life events and higher HIV RNA levels, were also associated with nonadherence. Knowledge of behavioral, health, and social influences affecting the child and family should guide the development of appropriate, evidence-based interventions for medication adherence.

PMID:
21323533
[PubMed - indexed for MEDLINE]
PMCID:
PMC3101948
Free PMC Article
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