title: Factors associated with self-reported adherence among adolescents on antiretroviral therapy in Zimbabwe.
abstract: Nonadherence to medication is the key obstacle to human immunodeficiency virus (HIV) treatment success. The group at highest risk of nonadherence is adolescents, but relatively little is known about risk factors for and protective factors against poor adherence in this age group. We undertook a cross-sectional study of 262 HIV-infected adolescents aged 10-19 years on antiretroviral therapy at two clinics in Harare, Zimbabwe, to investigate personal and system-level factors associated with optimal self-reported adherence. Suboptimal adherence was common with only 101 (39%) reporting "excellent" adherence. Having the guardian present at each clinical encounter, comfort with asking questions to the health provider and participating in group sessions led by a professional facilitator were all significantly associated with excellent adherence (p < 0.05). Strengthening the parent-child dyad and professional-led groups as strategies to improve adherence should be evaluated.
authors.affiliation: a Center for Clinical Epidemiology & Biostatistics (CCEB), Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Gross
authors.forename: Tsitsi
authors.initials: T
authors.lastname: Bandason
authors.forename: Lisa
authors.initials: L
authors.lastname: Langhaug
authors.forename: Hilda
authors.initials: H
authors.lastname: Mujuru
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lowenthal
authors.forename: Rashida
authors.initials: R
authors.lastname: Ferrand
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002648:Child; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D012307:Risk Factors; D057566:Self Report; D015030:Zimbabwe / Q000453:epidemiology; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents
keywords: HIV-1; adolescents; antiretroviral therapy; medication adherence