title: Social ecological predictors of longitudinal HIV treatment adherence in youth with perinatally acquired HIV.
abstract: OBJECTIVE
  To apply a social ecological model to explore the psychosocial factors prospectively associated with longitudinal adherence to antiretroviral treatment in youth perinatally infected with HIV.
  
  
  METHODS
  Randomly selected youth, age 8 to <19 years old, completed cognitive testing and psychosocial questionnaires at baseline as part of a multisite protocol (N = 138). A validated caregiver-report measure of adherence was completed at baseline and 24 and 48 weeks after baseline.
  
  
  RESULTS
  In multivariate analysis, youth awareness of HIV status, caregiver not fully responsible for medications, low caregiver well-being, adolescent perceptions of poor caregiver-youth relations, caregiver perceptions of low social support, and African American ethnicity were associated with nonadherence over 48 weeks.
  
  
  CONCLUSIONS
  Interventions focusing on caregivers and their interactions with the individual youth and extrafamilial system should be prioritized for prevention and treatment efforts to address nonadherence during the transition into adolescents.
authors: Carman and Ann Adams Department of Pediatrics, Wayne State University, Detroit, MI, USA. snaarkin@med.wayne.edu
authors: Sylvie
authors: S
authors: Naar-King
authors: Grace
authors: G
authors: Montepiedra
authors: Patricia
authors: P
authors: Garvie
authors: Betsy
authors: B
authors: Kammerer
authors: Kathleen
authors: K
authors: Malee
authors: Patricia A
authors: PA
authors: Sirois
authors: Lisa
authors: L
authors: Aaron
authors: Sharon L
authors: SL
authors: Nichols
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D017028:Caregivers / Q000523:psychology; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006679:HIV Seropositivity; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; antiretroviral therapy; children; patient adherence
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