HIV treatment adherence measurement and reporting concordance in youth with perinatally acquired HIV infection and their caregivers.
We examined youth-caregiver adherence report concordance and association of different adherence self-report items with HIV RNA viral load (VL) in perinatally HIV-infected adolescents assessed in 2003-2008. Youth (n=194; 9-19 years) and their caregivers completed a multi-step 2-day recall, one item on last time medications were missed, and one item on responsibility for managing youths' medications. Across early (9-12 years), middle (13-15 years), and late (16+years) adolescence, both youth and caregivers reported having primary responsibility for youths' medication regimens and demonstrated poor to moderate youth-caregiver concordance on adherence items. Responses to the last-time-missed item had greater association with VL than did the 2-day recall, particularly for longer times (e.g., past month). By age group, significant associations with VL were found for caregiver reports in early adolescence, caregiver and youth reports in middle adolescence, and youth reports in late adolescence, suggesting that caregivers offer better reports of youth adherence during early adolescence, but by later adolescence, youth are better informants. Although design limitations preclude definitive conclusions about the reliability and validity of specific adherence items, this study suggests important issues related to age group, caregiver vs. youth informants of adherence, and recall periods for child adherence assessment that warrant further research.
1 HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute , New York, New York.
Shenell D
SD
Evans
Claude Ann
CA
Mellins
Cheng-Shiun
CS
Leu
Patricia
P
Warne
Katherine S
KS
Elkington
Curtis
C
Dolezal
E Karina
EK
Santamaria
Andrew
A
Wiznia
Mahrukh
M
Bamji
Andrea S
AS
Jurgrau-Voulgari
Elaine J
EJ
Abrams
D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D017028:Caregivers; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D015999:Multivariate Analysis; D009519:New York City; D010290:Parents; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D019562:Viral Load; D055815:Young Adult; D016903:Drug Monitoring
D044966:Anti-Retroviral Agents