Compliance With Meds Falters With Age in Youth Born With HIV

For adolescents with perinatally acquired HIV, the prevalence of medication nonadherence and unsuppressed viral load increases with age, according to a study published online in AIDS.

Deborah Kacanek, Sc.D., from the Harvard T.H. Chan School of Public Health in Boston, and colleagues conducted a longitudinal study at 15 U.S. clinical sites to examine factors associated with nonadherence and unsuppressed viral load across adolescence among 381 youth with perinatally acquired HIV. Self-reported antiretroviral medication nonadherence and unsuppressed viral load were measured annually.

The researchers found that the prevalence of nonadherence increased from 31 to 50 percent from preadolescence (8 to 11 years) to late adolescence/young adulthood (19 to 22 years), and unsuppressed viral load prevalence increased from 16 to 40 percent. Perceived antiretroviral side effects correlated with nonadherence in adjusted analyses in preadolescence/young adulthood, middle adolescence/young adulthood (age 15 to 17 years), and late adolescence/young adulthood. Additional factors associated with nonadherence included use of a buddy system (as an adherence reminder) in preadolescence; identifying as black and use of a buddy system in early adolescence (age 12 to 14 years); and CD4+ less than 15 percent, unmarried caregiver, indirect exposure to violence, stigma/fear of inadvertent disclose, and stressful life events in middle adolescence.

"Services to help adolescents with perinatally-acquired HIV navigate typical developmental challenges should recognize age-specific risks and build on sources of resilience at individual, family, social, and structural levels," the authors write.

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