Maria L S Cruz1, Claudete A A Cardoso2, Mariana Q Darmont3, Edvaldo Souza4, Solange D Andrade5, Marcia M D'Al Fabbro6, Rosana Fonseca7, Jaime G Bellido8, Simone S Monteiro9, Francisco I Bastos8. 1. Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, RJ, Brazil; Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil. Electronic address: mleticia@diphse.com.br. 2. Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil. 3. Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil. 4. Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil. 5. Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, AM, Brazil. 6. Centro de Doenças Infecciosas e Parasitárias, Campo Grande, MS, Brazil. 7. Hospital Fêmina, Porto Alegre, RS, Brazil. 8. Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil. 9. Instituto Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
Abstract
OBJECTIVE: To evaluate treatment adherence among perinatally-infected pediatric human immunodeficiency virus (HIV) patients followed in pediatric centers in Brazil. METHODS: This was a cross-sectional multicenter study. Medical records were reviewed and adherence scale, assessment of caregivers' quality of life (WHOQOL-BREF), anxiety, depression, and alcohol/substances use/abuse were assessed. Outcomes included self-reported 100% adherence in the last three days and HIV viral load (VL)<50 copies/mL. Statistical analyses included contingency tables and respective statistics, and multivariable logistic regression. RESULTS: 260 subjects were enrolled: 78% children and 22% adolescents; 93% of caregivers for the children and 77% of adolescents reported 100% adherence; 57% of children and 49% of adolescents had VL<50 copies/mL. In the univariate analyses, HIV diagnosis for screening due to maternal infection, lower caregiver scores for anxiety, and higher scores in physical and psychological domains of WHOQOL-BREF were associated with 100% adherence. Shorter intervals between pharmacy visits were associated with VL<50 copies/mL (p ≤ 0.01). Multivariable regression demonstrated that caregivers who did not abuse alcohol/other drugs (OR=0.49; 95% CI: 0.27-0.89) and median interval between pharmacy visits<33 days (OR=0.97; 95% CI: 0.95-0.98) were independently associated with VL<50 copies/mL; whereas lower caregiver scores for anxiety (OR=2.57; 95% CI: 1.27-5.19) and children's HIV diagnosis for screening due to maternal infection (OR=2.25; 95% CI: 1.12-4.50) were found to be independently associated with 100% adherence. CONCLUSIONS: Pediatric HIV programs should perform routine assessment of caregivers' quality of life, and anxiety and depression symptoms. In this setting, pharmacy records are essential to help identify less-than-optimal adherence.
OBJECTIVE: To evaluate treatment adherence among perinatally-infected pediatric human immunodeficiency virus (HIV) patients followed in pediatric centers in Brazil. METHODS: This was a cross-sectional multicenter study. Medical records were reviewed and adherence scale, assessment of caregivers' quality of life (WHOQOL-BREF), anxiety, depression, and alcohol/substances use/abuse were assessed. Outcomes included self-reported 100% adherence in the last three days and HIV viral load (VL)<50 copies/mL. Statistical analyses included contingency tables and respective statistics, and multivariable logistic regression. RESULTS: 260 subjects were enrolled: 78% children and 22% adolescents; 93% of caregivers for the children and 77% of adolescents reported 100% adherence; 57% of children and 49% of adolescents had VL<50 copies/mL. In the univariate analyses, HIV diagnosis for screening due to maternal infection, lower caregiver scores for anxiety, and higher scores in physical and psychological domains of WHOQOL-BREF were associated with 100% adherence. Shorter intervals between pharmacy visits were associated with VL<50 copies/mL (p ≤ 0.01). Multivariable regression demonstrated that caregivers who did not abuse alcohol/other drugs (OR=0.49; 95% CI: 0.27-0.89) and median interval between pharmacy visits<33 days (OR=0.97; 95% CI: 0.95-0.98) were independently associated with VL<50 copies/mL; whereas lower caregiver scores for anxiety (OR=2.57; 95% CI: 1.27-5.19) and children's HIV diagnosis for screening due to maternal infection (OR=2.25; 95% CI: 1.12-4.50) were found to be independently associated with 100% adherence. CONCLUSIONS: Pediatric HIV programs should perform routine assessment of caregivers' quality of life, and anxiety and depression symptoms. In this setting, pharmacy records are essential to help identify less-than-optimal adherence.
Authors: Hanalise V Huff; Paloma M Carcamo; Monica M Diaz; Jamie L Conklin; Justina Salvatierra; Rocio Aponte; Patricia J Garcia Journal: Int J Environ Res Public Health Date: 2022-06-12 Impact factor: 4.614
Authors: Rashida A Ferrand; Datonye Briggs; Jane Ferguson; Martina Penazzato; Alice Armstrong; Peter MacPherson; David A Ross; Katharina Kranzer Journal: Trop Med Int Health Date: 2016-01-10 Impact factor: 2.622
Authors: Maria Letícia Santos Cruz; Claudete A Araújo Cardoso; Mariana Q Darmont; Paulo Dickstein; Francisco I Bastos; Edvaldo Souza; Solange D Andrade; Marcia D'All Fabbro; Rosana Fonseca; Simone Monteiro Journal: Int J Environ Res Public Health Date: 2016-06-21 Impact factor: 3.390