multiple measures reveal antiretroviral adherence successes and challenges in hiv-infected ugandan children多个度量揭示抗逆转录病毒感染艾滋病毒的乌干达儿童的坚持成就和面临的挑战.pdfVIP

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multiple measures reveal antiretroviral adherence successes and challenges in hiv-infected ugandan children多个度量揭示抗逆转录病毒感染艾滋病毒的乌干达儿童的坚持成就和面临的挑战.pdf

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multiple measures reveal antiretroviral adherence successes and challenges in hiv-infected ugandan children多个度量揭示抗逆转录病毒感染艾滋病毒的乌干达儿童的坚持成就和面临的挑战

Multiple Measures Reveal Antiretroviral Adherence Successes and Challenges in HIV-Infected Ugandan Children 1,2 3 3 1 4 Jessica E. Haberer *, Julius Kiwanuka , Denis Nansera , Kathleen Ragland , Claude Mellins , David R. Bangsberg1,2 1 Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 2 Harvard Medical School, Boston, Massachusetts, United States of America, 3 Department of Paediatrics, Mbarara University of Science and Technology, Mbarara, Uganda, 4 Departments of Psychiatry and Sociomedical Sciences, Columbia University, New York, New York, United States of America Abstract Background: Adherence to HIV antiretroviral therapy (ART) among children in developing settings is poorly understood. Methodology/Principal Findings: To understand the level, distribution, and correlates of ART adherence behavior, we prospectively determined monthly ART adherence through multiple measures and six-monthly HIV RNA levels among 121 Ugandan children aged 2–10 years for one year. Median adherence levels were 100% by three-day recall, 97.4% by 30-day visual analog scale, 97.3% by unannounced pill count/liquid formulation weights, and 96.3% by medication event monitors (MEMS). Interruptions in MEMS adherence of $48 hours were seen in 57.0% of children; 36.3% had detectable HIV RNA at one year. Only MEMS correlated significantly with HIV RNA levels (r = 20.25, p = 0.04). Multivariable regression found the following to be associated with ,90% MEMS adherence: hospitalization of child (adjusted odds ratio [AOR] 3.0, 95% confidence interval [CI] 1.6–5.5; p = 0.001), liquid formulation use (AOR 1.4, 95%CI 1.0–2.0; p = 0.04), and caregiver’s alcohol use (AOR 3.1, 95%CI 1.8–5.2; p,0.000