Barriers to Medication Adherence in HIV-Infected Children and Youth Based on Self- and Caregiver Report
Pediatrics, 05/11/2012

Buchanan AL et al. – Lack of agreement was observed for more than half of the studied barriers, indicating discrepancies between children’s and caregivers’ perceptions of factors that influence medication–taking. The findings suggest a need for interventions that involve both child and caregiver in the tasks of remembering when to administer the child’s medications, sustaining adherence, and appropriately transitioning medication responsibility to the youth.

• Children/youth with perinatally acquired HIV and their parents/caregivers (n = 120 dyads) completed a questionnaire about 19 potential barriers to adherence to the child’s antiretroviral therapy regimen.
• Agreement between the 2 reports was measured via the kappa statistic.
• Factors associated with the barriers were assessed by using multiple logistic regression.

• Of the 120 children, 55% were African American, 54% were boys, and the average age was 12.8 years.
• The most frequently reported barrier by either the caregiver or youth was “forgot.”
• There were varying degrees of agreement between child and caregiver on the following barriers: “forgot,” “taste,” “child was away from home,” “child refused,” and “child felt good.”
• Children who knew their HIV status were more likely to report logistical barriers, such as scheduling issues.
• Children with a biological parent as their caregiver were more likely to report regimen or fear of disclosure as a barrier.