Explaining Antiretroviral Therapy Adherence Success Among HIV-Infected Children in Rural Uganda: A Qualitative Study

Olds, Peter; Kiwanuka, Julius; Ware, Norma; Tsai, Alexander; Haberer, Jessica
April 2015
AIDS & Behavior;Apr2015, Vol. 19 Issue 4, p584
Academic Journal
High adherence is critical for achieving clinical benefits of HIV antiretroviral therapy (ART) and particularly challenging for children. We conducted 35 qualitative interviews with caregivers of HIV-infected Ugandan children who were followed in a longitudinal study of real-time ART adherence monitoring; 18 participants had undetectable HIV RNA, while 17 had detectable virus. Interviews blinded to viral suppression status elicited information on adherence experiences, barriers and facilitators to adherence, and social support. Using an inductive content analytic approach, we identified 'lack of resources,' 'Lazarus effect,' 'caregiver's sense of obligation and commitment,' and 'child's personal responsibility' as categories of influence on adherence, and defined types of caregiver social support. Among children with viral suppression, high hopes for the child's future and ready access to private instrumental support appeared particularly important. These findings suggest clinical counseling should explore caregivers' views of their children's futures and ability to access support in overcoming adherence barriers. Resumen: Gran adherencia es fundamental para el logro de los beneficios clínicos de la terapia antirretroviral contra el VIH y es particularmente difícil para los niños. Hemos llevado a cabo 35 entrevistas cualitativas a los cuidadores de los niños Ugandeses infectados por el VIH que fueron seguidos en un estudio longitudinal de la supervisión del adherencia terapéutico antirretroviral en tiempo real; 18 participantes tenían indetectable de ARN del VIH, mientras que 17 tenían virus detectable. Entrevistas sin conocimiento al estado de supresión viral provocaron información sobre las experiencias de adherencia, barreras y facilitadores para la adhesión y el apoyo social. El uso de un enfoque analítico contenido inductivo, hemos identificado 'falta de recursos', 'efecto Lázaro', 'sentido del cuidador de la obligación y compromiso', y 'la responsabilidad personal del niño' como las categorías de influencia en la adherencia y tipos definidos de apoyo social del cuidador. Entre los niños con la supresión viral, grandes esperanzas para el futuro acceso y listo del niño para el apoyo instrumental privada parecían especialmente importantes. Estos hallazgos sugieren asesoramiento clínico debe explorar puntos de vista de los cuidadores de futuro de sus hijos y la posibilidad de acceder a la ayuda en la superación de las barreras de adherencia.


Related Articles

  • Barriers to and Facilitators of Adherence to Pediatric Antiretroviral Therapy in a Sub-Saharan Setting: Insights from a Qualitative Study. Fetzer, Bradley C.; Mupenda, Bavon; Lusiama, Jean; Kitetele, Faustin; Golin, Carol; Behets, Frieda // AIDS Patient Care & STDs;Oct2011, Vol. 25 Issue 10, p611 

    Despite the need for HIV-positive children to adhere effectively to antiretroviral treatment (ART), a guiding theory for pediatric ART in resource-limited settings is still missing. Understanding factors that influence pediatric ART adherence is critical to developing adequate strategies....

  • Social Representations of AIDS and their Quotidian Interfaces for People Living with HIV. Gomes, Antonio Marcos Tosoli; Silva, Érika Machado Pinto; de Oliveira, Denize Cristina // Revista Latino-Americana de Enfermagem (RLAE);May/Jun2011, Vol. 19 Issue 3, p485 

    This qualitative descriptive study, guided by the Social Representations Theory, aimed to describe the content of the social representations regarding the Acquired Immunodeficiency Syndrome (AIDS) for seropositive individuals in outpatient monitoring of the public health network and to analyze...

  • Optimizing Content for Pre-exposure Prophylaxis (PrEP) Counseling for Men Who Have Sex with Men: Perspectives of PrEP Users and High-Risk PrEP Naïve Men. Wade Taylor, S.; Mayer, Kenneth; Elsesser, Steven; Mimiaga, Matthew; O'Cleirigh, Conall; Safren, Steven // AIDS & Behavior;May2014, Vol. 18 Issue 5, p871 

    Existing trials of antiretroviral (ARV) medication as chemoprophylaxis against HIV reveal that the degree of protection is primarily dependent on product adherence. However, there is a lack of data on targets for behavioral interventions to improve adherence to ARV as prevention. Information...

  • Viral Suppression and Antiretroviral Medication Adherence Among Alcohol Using HIV-Positive Adults. Kalichman, Seth; Grebler, Tamar; Amaral, Christina; McNerney, Megan; White, Denise; Kalichman, Moira; Cherry, Chauncey; Eaton, Lisa // International Journal of Behavioral Medicine;Oct2014, Vol. 21 Issue 5, p811 

    Background: Substance use is a known predictor of poor adherence to antiretroviral therapies (ART) in people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Less studied is the association between substance use and treatment outcomes, namely, suppression of HIV...

  • Perspectives on HIV Prevention Among Urban Black Women: A Potential Role for HIV Pre-Exposure Prophylaxis. Flash, Charlene A.; Stone, Valerie E.; Mitty, Jennifer A.; Mimiaga, Matthew J.; Hall, Kathryn T.; Krakower, Douglas; Mayer, Kenneth H. // AIDS Patient Care & STDs;Dec2014, Vol. 28 Issue 12, p635 

    Limited data exist regarding attitudes and acceptability of topical and oral HIV pre-exposure prophylaxis (PrEP) among US black women. This investigation explored interest in HIV chemoprophylaxis and modes of use. Five focus groups enrolled 26 black women recruited from an inner-city community...

  • Food insecurity is associated with poor virologic response among HIV-infected patients receiving antiretroviral medications. Wang, Emily A.; McGinnis, Kathleen A.; Fiellin, David A.; Goulet, Joseph L.; Bryant, Kendall; Gibert, Cynthia L.; Leaf, David A.; Mattocks, Kristin; Sullivan, Lynn E.; Vogenthaler, Nicholas; Justice, Amy C.; VACS Project Team // JGIM: Journal of General Internal Medicine;Sep2011, Vol. 26 Issue 9, p1012 

    Background and Objective: Food insecurity negatively impacts HIV disease outcomes in international settings. No large scale U.S. studies have investigated the association between food insecurity and severity of HIV disease or the mechanism of this possible association. The objective...

  • PERCEPCÃO DOS USUARIOS SOBRE ADESÃO À TERAPIA ANTIRRETROVIRAL DE ALTA ATIVIDADE. Sandra Andrade, Maria; Freite Silva, Alexsandra; Kelley Medeiros, Ana; Wildysleya Nascimento, Patrícya // Revista de Atencao Primaria a Saude;jul-set2012, Vol. 15 Issue 3, p299 

    The success of antiretroviral therapy depends on maintaining high rates of adherence to treatment. This article aims to assess the perception of users in high activity antiretroviral therapy in relation to the partnership afforded by health professionals, seeking to ascertain the difficulties in...

  • STAGES OF CHANGE IN HIV CARRIERS OF THE SELF-HELP GROUP. Souza Pinto, Agnes Caroline; Teles Fiuza, Maria Luciana; da Costa Pinheiro, Patrícia Neyva; Cunha Vieira, Neiva Francenely; Teresinha Gimeniz Galvão, Marli // Journal of Nursing UFPE / Revista de Enfermagem UFPE;Sep2014, Vol. 8 Issue 9, p3076 

    No abstract available.

  • The challenges experienced by nongovernmental organisations with regard to the roll-out of antiretroviral therapy in KwaZulu-Natal. Michel, J.; Matlakala, M. C. // South African Family Practice;May/Jun2013, Vol. 55 Issue 3, p264 

    Background: Successful administration of antiretroviral therapy (ART) requires full adherence to the regimen by the patient. The introduction of ART needs a well-functioning health system with adequately trained health professionals, laboratory support, a constant supply of drugs and social...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics