Correlates of Adherence to Antiretroviral Therapy in HIV-Infected Children in Lomé, Togo, West Africa
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We assessed pediatric adherence to antiretroviral therapy (ART) and examined associated factors among children in Togo, West Africa. Structured interviews of caregivers of consecutively enrolled HIV-infected children receiving ART in three HIV/AIDS care centers in Lome, Togo were conducted. Child perfect adherence reflected caregivers’ report of no antiretroviral drug doses missed neither in the past 4 days nor in the month before the interview. A total of 74 ART-treated children were included (median age 6 years). Of these, 42% of caregivers declared perfect adherence. In univariate analyses, the major factors relating to child non-adherence were: being female, living in an individual setting (vs. compound with enlarged family), receiving other ART than an NNRT-based regimen, drug regimens with six pills/spoons or more per day, caregiver other than biological parent, caregiver not declaring HIV-status, not participating to support groups and having perceived difficulty of antiretroviral (ARV) administration. In multivariate analysis, female gender, living in an individual setting, receiving other than NNRTI-based regimen and caregivers’ perceived difficulty of ARV administration remained independently associated with the reported child’s non-adherence. These data show low rates of perfect adherence to ART in children in West Africa, influenced by child and caregiver characteristics and suggest a need for counseling and education interventions as well as continuous psychological and social support.
KeywordsAdherence Antiretroviral therapy Correlates Children Africa
The authors would like to acknowledge the French association “Initiative Développement” as well as the staff of the NGOs “Action contre le SIDA”, “Aides Médicales et Charité” and « Espoir Vie Togo”, based in Lome, Togo for their support for this study. We are grateful to the caregivers and children for their participation in the interviews. Comments during the preparation of the manuscript from Isabelle Gobatto, Marthe-Aline Jutand, Anne Tijou-Traoré and Francois Dabis are greatly valued. We also thank two AIDS and Behavior reviewers for their useful comments and suggestions.
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