title: Children and Adolescents with Perinatal HIV-1 Infection: Factors Associated with Adherence to Treatment in the Brazilian Context.
abstract: Challenges to the adherence to combination antiretroviral therapy among the pediatric population should be understood in the context of the trajectories of families, their interaction with healthcare services, and their access to material and symbolic goods. The present study analyzed individual, institutional and social factors that might be associated with the caregivers' role in the treatment adherence of children and adolescents living with HIV (CALHIV). Based on semi-structured interviews and questionnaires applied to 69 caregivers seen at pediatric AIDS services of five Brazilian macro-regions, we observed that adherent caregivers had better acceptance of diagnosis and treatment, were less likely to face discrimination and social isolation secondary to AIDS-related stigma and tended to believe in the efficacy of treatment, and to be more optimistic about life perspectives of CALHIV. Interventions aiming to improve adherence and to promote the health of CALHIV should take in consideration the interplay of such different factors.
authors.affiliation: Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rua Sacadura Cabral 178, Rio de JaneiroRJ 20221-161, Brazil. mleticia@diphse.com.br.
authors.forename: Maria Letícia Santos
authors.initials: ML
authors.lastname: Cruz
authors.affiliation: Department of Maternal and Child Care, School of Medicine, Fluminense Federal University, Rua Marqu&#234;s de Paran&#225;, 303, Niter&#243;i RJ 24033-900, Brazil. claudetecardoso@id.uff.br.
authors.forename: Claudete A Araújo
authors.initials: CA
authors.lastname: Cardoso
authors.affiliation: Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rua Sacadura Cabral 178, Rio de JaneiroRJ 20221-161, Brazil. marianadarmont@gmail.com.
authors.forename: Mariana Q
authors.initials: MQ
authors.lastname: Darmont
authors.affiliation: Infectious Diseases Department, Hospital Federal dos Servidores do Estado, Rua Sacadura Cabral 178, Rio de JaneiroRJ 20221-161, Brazil. paulo.dickstein@gmail.com.
authors.forename: Paulo
authors.initials: P
authors.lastname: Dickstein
authors.affiliation: Health Information, Funda&#231;&#227;o Oswaldo Cruz, Biblioteca de Manguinhos suite 229, Av. Brasil 4365, Rio de Janeiro RJ 21045-900, Brazil. francisco.inacio.bastos@hotmail.com.
authors.forename: Francisco I
authors.initials: FI
authors.lastname: Bastos
authors.affiliation: Department of Pediatrics, Instituto de Medicina Integral Prof. Fernando Figueira, Rua dos Coelhos 300, Recife PE 50070-550, Brazil. edvaldo.es@gmail.com.
authors.forename: Edvaldo
authors.initials: E
authors.lastname: Souza
authors.affiliation: Department of Pediatrics, Funda&#231;&#227;o de Medicina Tropical Dr. Heitor Vieira Dourado, Av. Pedro Teixeira 25, D Pedro I, Manaus AM 69040-000, Brazil. douradosol@yahoo.com.br.
authors.forename: Solange D
authors.initials: SD
authors.lastname: Andrade
authors.affiliation: Centro de Doen&#231;as Infecciosas e Parasit&#225;rias de Campo Grande, Rua Bahia 280, Jardim dos Estados, Campo Grande MS 79002-380, Brazil. fabbro@uol.com.br.
authors.forename: Marcia D'All
authors.initials: MD
authors.lastname: Fabbro
authors.affiliation: Department of Pediatrics, Hospital F&#234;mina, Grupo Hospitalar Concei&#231;&#227;o, Rua Mostardeiro 17, Moinhos de Vento, Porto Alegre RS 90430-001, Brazil. rosana040@yahoo.com.br.
authors.forename: Rosana
authors.initials: R
authors.lastname: Fonseca
authors.affiliation: Laboratory of Environmental and Health Education, Instituto Oswaldo Cruz, Fiocruz. Av. Brasil 4365, Rio de Janeiro RJ 21045-900, Brazil. msimone@ioc.fiocruz.br.
authors.forename: Simone
authors.initials: S
authors.lastname: Monteiro
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001938:Brazil; D017028:Caregivers; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D008297:Male; D055118:Medication Adherence; D057545:Social Stigma; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents
keywords: HIV infection; adolescents; caregivers; children; patient adherence; vulnerability