Disclosure of HIV Status and Adherence to Daily Drug Regimens Among HIV-infected Children in Uganda
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Pediatric adherence to daily drug regimens has not been widely assessed in Africa where majority of HIV infected children live. Using in-depth interviews of 42 HIV-infected children taking ART and/or cotrimoxazole prophylaxis, and 42 primary caregivers, at a comprehensive HIV/AIDS clinic in Uganda, we evaluated their adherence experiences for purposes of program improvement. Daily drug regimens provided by the pediatric clinic included cotrimoxazole prophylaxis as well as ART and cotrimoxazole combined. Complete disclosure of HIV status by caregivers to children and strong parental relationships were related to good adherence. Structural factors including poverty and stigma were barriers to adherence even for children who had had complete disclosure and a supportive relationship with a parent. To ensure adherence to life-extending medications, our findings underscore the need for providers to support caregivers to disclose, provide on-going support and maintain open communication with HIV-infected children taking cotrimoxazole prophylaxis and ART.
KeywordsPediatrics AIDS Adherence Antiretrovirals Cotrimoxazole
We thank Mildmay Centre staff and clients and Centres for Disease Control staff for all their time and efforts. E. Ezati, R. Nasaba, J. Kalyebara, R. Ingabire and M. Butamanya conducted the interviews, R. Apondi, S. Nakayiwa and F. Bloom with data analysis and S. Bechange and R. Batamwita assisted with data management. We also thank G. Rutherford, R. King and R. Stall, for their comments on earlier versions of this manuscript and T. Wamala for her assistance with the references.
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