Pediatric HIV medication adherence: the views of medical providers from two primary care programs.
BACKGROUND
The purpose of this study was to examine medical providers' views from two primary care programs regarding adherence to antiretroviral therapy among HIV-infected children.


METHODS
Ten medical providers (five physicians and five registered nurses) working with perinatally HIV-infected children completed a structured questionnaire examining provider-patient/family relationship and participated in an individual qualitative interview regarding providers' views on pediatric adherence to antiretroviral therapy.


RESULTS
Providers believed that the limited treatment options currently available to HIV-infected children presented families with tremendous challenges to adherence. Most children were prescribed difficult treatment regimens and needed increasingly complex regimens for possible success in the future, placing further demands on the adherence issue. Although providers were able to identify several helpful communication strategies in theory, they were not able to consistently implement them in practice. Further, many families are also struggling with poverty, mental health and substance use problems, additional HIV disease in the family, and disclosure issues.


CONCLUSIONS
Adherence to antiretroviral therapy is a long-term, ongoing problem that is directly tied to the family life of the HIV-infected child. Providers clearly play an integral part in this struggle.
Department of Psychiatry, Columbia University, USA. eb372@columbia.edu
Elizabeth
E
Brackis-Cott
Claude Ann
CA
Mellins
Elaine
E
Abrams
Tejas
T
Reval
Curtis
C
Dolezal
D000998:Antiviral Agents / Q000008:administration & dosage*; D017028:Caregivers; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006282:Health Personnel; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010349:Patient Compliance; D010372:Pediatrics; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D014342:Truth Disclosure
D000998:Antiviral Agents