title: Correlates of adherence to antiretroviral therapy in HIV-infected children in Lomé, Togo, West Africa.
abstract: We assessed pediatric adherence to antiretroviral therapy (ART) and examined associated factors among children in Togo, West Africa. Structured interviews of caregivers of consecutively enrolled HIV-infected children receiving ART in three HIV/AIDS care centers in Lome, Togo were conducted. Child perfect adherence reflected caregivers' report of no antiretroviral drug doses missed neither in the past 4 days nor in the month before the interview. A total of 74 ART-treated children were included (median age 6 years). Of these, 42% of caregivers declared perfect adherence. In univariate analyses, the major factors relating to child non-adherence were: being female, living in an individual setting (vs. compound with enlarged family), receiving other ART than an NNRT-based regimen, drug regimens with six pills/spoons or more per day, caregiver other than biological parent, caregiver not declaring HIV-status, not participating to support groups and having perceived difficulty of antiretroviral (ARV) administration. In multivariate analysis, female gender, living in an individual setting, receiving other than NNRTI-based regimen and caregivers' perceived difficulty of ARV administration remained independently associated with the reported child's non-adherence. These data show low rates of perfect adherence to ART in children in West Africa, influenced by child and caregiver characteristics and suggest a need for counseling and education interventions as well as continuous psychological and social support.
authors.affiliation: Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Victor Segalen Bordeaux 2, Case 11, 146 Rue Leo Saignat, 33076, Bordeaux Cedex, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Polisset
authors.forename: Francine
authors.initials: F
authors.lastname: Ametonou
authors.forename: Elise
authors.initials: E
authors.lastname: Arrive
authors.forename: Anthony
authors.initials: A
authors.lastname: Aho
authors.forename: Freddy
authors.initials: F
authors.lastname: Perez
mesh_terms: D000293:Adolescent; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D017028:Caregivers / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D012737:Sex Factors; D018709:Statistics, Nonparametric; D014037:Togo / Q000453:epidemiology; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents