title: Importance of Self-Motivation and Social Support in Medication Adherence in HIV-Infected Adolescents in the United Kingdom and Ireland: A Multicentre HYPNet Study.
abstract: Adolescents are a vulnerable population, not only to the acquisition of HIV, but also to poor adherence to antiretroviral therapy (ART) associated with disease progression and a increased risk of onward viral transmission. The aim of the study was to examine the factors that aid or act as barriers to adherence in a UK population of adolescents and young adults receiving ART. A cross-sectional survey was completed of 138 adolescents (12-24 years) across 14 clinical and community sites in the UK and Ireland. Analysis of results was undertaken using Chi-square testing in SPSS. Of the 138 patients, 48% were female, and 52% were born outside of the UK. Fifty-two of the 138 (43%) reported being on ART for at least 8 years. More than a third of the patients have ever interrupted treatment since initiating ART. One hundred four of the 138 (75%) patients self-reported being >85% adherent to medication for 7 day recall. Self-motivation (e.g., having a routine, specific goal) was cited as being most helpful in medication compliance (33%), followed by reminders by friends and family (25%), with 20% identifing no specific factor. Only 15% chose interventions such as an adherence diary or mobile phone reminders as helpful factors, and 1% chose healthcare professional input such as home visits. This study highlights the importance of self-motivation and social support in medication adherence in an HIV-infected adolescent population, in preference to healthcare professional input. Education and motivational strategies may confer the biggest impact on sustained ART adherence amongst this vulnerable group.
authors.affiliation: 1School of Medicine, Imperial College London, London, United Kingdom.
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Kim
authors.affiliation: 2Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Susan
authors.initials: S
authors.lastname: McDonald
authors.affiliation: 1School of Medicine, Imperial College London, London, United Kingdom.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kim
authors.affiliation: 2Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Caroline
authors.initials: C
authors.lastname: Foster
authors.affiliation: 2Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fidler
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007494:Ireland; D008297:Male; D055118:Medication Adherence; D009042:Motivation; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014505:Urban Population; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents