title: Analysis of the social and psychosocial factors associated with adherence to antiretroviral therapy in adolescents with perinatal HIV-1 infection in Panama from a gender perspective.
abstract: Adherence is vital for an effective antiretroviral treatment. This cross-sectional study explored social and psychosocial factors associated with adherence among adolescents with perinatal human immunodeficiency virus type 1 infection in Panama from a gender perspective. A questionnaire developed for the study was applied to 38 adolescent patients (20 female, 18 male; median age, 14 years). Thirty-two patients (86%; one missing response) still depended on an adult to remember taking their medication, among whom 28 relied on a female relative. Although 18 (47%) patients reported to become ill no more than once a year, only 10 (26%) patients showed an undetectable viral load, and 4 (11%) patients showed no CD4 suppression. Seventeen (45%) patients recalled correctly their medication. During the week prior to the interview, 26 patients (68%) reported that they had missed at least one dose. When asked the reason for missing a dose, 23 out of 34 (68%; 4 missing responses) patients responded, "I forgot". Female patients gave more excuses for missing doses (mean ± SD number of excuses per female, 2.4 ± 2; per male, 1.2 ± 1; p = .02), while more male than female patients described an action plan if they ran out of medication (13 vs. 8; p = .05). Educational programs involving patients and also family members are warranted to improve adherence.
authors.affiliation: a Department of Infectious Diseases , Pediatric Hospital "Dr. Jose Renan Esquivel" , Panamá , Republic of Panamá
authors.forename: Dora
authors.initials: D
authors.lastname: Estripeaut
authors.affiliation: b Department of Infectious Diseases , Pediatric Specialties of Social Security Hospital "Dr. Arnulfo Arias" , Panamá , Republic of Panamá
authors.forename: Kathia
authors.initials: K
authors.lastname: Luciani
authors.affiliation: c ONUSIDA Panama , Panamá , Republic of Panamá
authors.forename: Ricardo
authors.initials: R
authors.lastname: García
authors.affiliation: d AID for AIDS Panama , Panamá , Republic of Panamá
authors.forename: Rita
authors.initials: R
authors.lastname: Banús
authors.affiliation: d AID for AIDS Panama , Panamá , Republic of Panamá
authors.forename: Trina María
authors.initials: TM
authors.lastname: Aguais
authors.affiliation: e UNFPA Panama , Panamá , Republic of Panamá
authors.forename: Edilma
authors.initials: E
authors.lastname: Berrío
authors.affiliation: f UNICEF Panama , Panamá , Republic of Panamá
authors.forename: Alma
authors.initials: A
authors.lastname: Jenkins
authors.affiliation: g Independent Statistical Advisor.
authors.forename: Sharene
authors.initials: S
authors.lastname: Smoot
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D015497:HIV-1; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D010176:Panama / Q000453:epidemiology; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D019562:Viral Load
keywords: Adolescents; adherence; psychosocial factors; retroviral therapy; social factors