Factors sustaining pediatric adherence to antiretroviral therapy in western Kenya.
Antiretroviral therapy (ART) requires nearly perfect adherence to be effective. Although 90% of HIV-infected children live in Africa, there are limited data on pediatric adherence from this multicultural continent.We conducted a qualitative study to identify key factors contributing to pediatric ART adherence. Ten focus group discussions (N = 85) and 35 individual interviews were conducted with parents and guardians of HIV-infected children receiving ART in western Kenya. Interviews covered multiple aspects of the experience of having children take ART and factors that inhibited or facilitated medication adherence. Constant comparison, progressive coding, and triangulation methods were used to arrive at a culturally contextualized, conceptual model for pediatric ART adherence derived from the descriptions of the lived experience in this resource-limited setting. Child care, including sustained ART adherence, depends on interacting cultural and environmental determinants at the levels of the individual child, parent/caregiver, household, community, health care system, and society.
Vreeman
Rachel C
RC
Indiana University School of Medicine, Department of Pediatrics, Children's Health Services Research, Indianapolis, Indiana 46202, USA. rvreeman@iupui.edu
Nyandiko
Winstone M
WM
Ayaya
Samwel O
SO
Walumbe
Eunice G
EG
Marrero
David G
DG
Inui
Thomas S
TS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003466:Cultural Characteristics; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology; D006801:Humans; D007223:Infant; D007630:Kenya; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D010349:Patient Compliance; D055815:Young Adult
D044966:Anti-Retroviral Agents