HIV treatment-related knowledge and self-efficacy among caregivers of HIV-infected children.
OBJECTIVE
Improvements in treatment-related knowledge and self-efficacy may improve clinical outcomes in HIV-infected populations. We examined whether caregivers' knowledge and self-efficacy was associated with better clinical outcomes and anti-retroviral therapy (ART) adherence among HIV-infected children.


METHODS
Caregivers of 77 perinatally HIV-infected children were administered a semi-structured interview which included scales of HIV treatment-related knowledge, adherence self-efficacy and caregiver reports of child medication adherence.


RESULTS
While caregivers correctly answered 74% of the knowledge questions, specific misconceptions were noted. Caregivers rated themselves as having high adherence self-efficacy, but were least confident in their ability to adhere to ART if it caused side effects or might result in social disclosure. Higher caregiver treatment-related knowledge and self-efficacy were associated with better clinical outcomes, as measured by viral load and CD4+ count, but not with caregiver reports of ART adherence.


CONCLUSIONS
While additional factors may be important determinants of adherence to ART in this population, improving the HIV treatment-related knowledge and self-efficacy of caregivers may help to improve the clinical outcomes of HIV-infected children.


CONCLUSIONS
Care providers should address both misconceptions that might serve to undermine adherence as well as factors that limit patients' self-efficacy in adhering to treatment, prior to the initiation of ART and throughout the course of treatment.
Nicholson
Ouzama
O
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, Box 15, 1051 Riverside Drive, New York, NY 10032, USA. on2014@columbia.edu
Mellins
Claude
C
Dolezal
Curtiz
C
Brackis-Cott
Elizabeth
E
Abrams
Elaine J
EJ
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education / Q000523:psychology; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology; D018791:CD4 Lymphocyte Count; D017028:Caregivers / Q000193:education* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004521:Educational Measurement; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006630:Hispanic or Latino / Q000193:education / Q000523:psychology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D009519:New York City; D010290:Parents / Q000193:education* / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D019562:Viral Load