Original Paper

AIDS and Behavior

, Volume 13, Issue 1, pp 82-91

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time

  • Jayne Byakika-TusiimeAffiliated withDepartment of Epidemiology, School of Public Health, University of California Berkeley Email author 
  • , Johanna CraneAffiliated withDepartment of Science and Technology Studies, Cornell University
  • , Jessica H. OyugiAffiliated withInfectious Diseases Institute
  • , Kathleen RaglandAffiliated withEpidemiology and Prevention Interventions Center, San Francisco General Hospital, Division of Infectious Diseases, University of California
  • , Annet KawumaAffiliated withDepartment of Community Health, Mbarara University of Science and Technology
  • , Philippa MusokeAffiliated withDepartment of Pediatrics and Child Health, Makerere UniversityMakerere University-Johns Hopkins University Research Collaboration
  • , David R. BangsbergAffiliated withMassachusetts General Hospital, Harvard Medical School, Harvard Initiative for Global Health


We conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.


Uganda Adherence Antiretroviral therapy Household MTCT-Plus