title: Improved Adherence to Antiretroviral Therapy Observed Among HIV-Infected Children Whose Caregivers had Positive Beliefs in Medicine in Sub-Saharan Africa.
abstract: A high level of adherence to antiretroviral treatment is essential for optimal clinical outcomes in HIV infection, but measuring adherence is difficult. We investigated whether responses to a questionnaire eliciting caregiver beliefs in medicines were associated with adherence of their child (median age 2.8 years), and whether this in turn was associated with viral suppression. We used the validated beliefs in medicine questionnaire (BMQ) to measure caregiver beliefs, and medication event monitoring system caps to measure adherence. We found significant associations between BMQ scores and adherence, and between adherence and viral suppression. Among children initiating Antiretroviral therapy (ART), we also found significant associations between BMQ 'necessity' scores, and BMQ 'necessity-concerns' scores, and later viral suppression. This suggests that the BMQ may be a valuable tool when used alongside other adherence measures, and that it remains important to keep caregivers well informed about the long-term necessity of their child's ART.
authors.affiliation: Joint Clinical Research Centre, Gulu, Uganda. gabongomera@jcrc.org.ug.|Faculty of Medicine, University of Antwerp, Antwerp, Belgium. gabongomera@jcrc.org.ug.
authors.forename: G
authors.initials: G
authors.lastname: Abongomera
authors.affiliation: Medical Research Council Clinical Trials Unit at University College London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Cook
authors.affiliation: Joint Clinical Research Centre, Kampala, Uganda.|Faculty of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: V
authors.initials: V
authors.lastname: Musiime
authors.affiliation: University Teaching Hospital, Lusaka, Zambia.
authors.forename: C
authors.initials: C
authors.lastname: Chabala
authors.affiliation: Infectious Diseases Institute, Kampala, Uganda.
authors.forename: M
authors.initials: M
authors.lastname: Lamorde
authors.affiliation: Joint Clinical Research Centre, Gulu, Uganda.
authors.forename: J
authors.initials: J
authors.lastname: Abach
authors.affiliation: Medical Research Council Clinical Trials Unit at University College London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Thomason
authors.affiliation: University Teaching Hospital, Lusaka, Zambia.
authors.forename: V
authors.initials: V
authors.lastname: Mulenga
authors.affiliation: Baylor-Uganda, Kampala, Uganda.
authors.forename: A
authors.initials: A
authors.lastname: Kekitiinwa
authors.affiliation: Faculty of Medicine, University of Antwerp, Antwerp, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Colebunders
authors.affiliation: Joint Clinical Research Centre, Kampala, Uganda.
authors.forename: C
authors.initials: C
authors.lastname: Kityo
authors.affiliation: Medical Research Council Clinical Trials Unit at University College London, London, UK.
authors.forename: A S
authors.initials: AS
authors.lastname: Walker
authors.affiliation: Medical Research Council Clinical Trials Unit at University College London, London, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Gibb
mesh_terms: D017954:Africa South of the Sahara; D000480:Alkynes; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D048588:Benzoxazines / Q000627:therapeutic use; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003521:Cyclopropanes; D015224:Dideoxynucleosides / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D019259:Lamivudine / Q000627:therapeutic use; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D015999:Multivariate Analysis; D019829:Nevirapine / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D018119:Stavudine / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D014454:Uganda; D015024:Zambia; D015215:Zidovudine / Q000627:therapeutic use; D000099227:Abacavir
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D015224:Dideoxynucleosides; D019259:Lamivudine; D019829:Nevirapine; D018119:Stavudine; D015215:Zidovudine; D000099227:Abacavir; C098320:efavirenz
keywords: Adherence; Antiretroviral therapy; Beliefs in medicine; Children; Sub-Saharan Africa