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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

By Jayne Tusiime | 22 May, 2009

This study looked at the effect on treatment adherence when everyone in a household who is eligible for antiretroviral treatment receives it. The study was conducted among HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Antiretroviral medications are provided at no cost to the patients in this program.We observed high adherence levels with a mean of over 94%. An important finding of this study was that adherence declined over time even when antiretroviral medications were provided at no cost to the patients. Previous studies have shown that cost of therapy was a major predictor of non-adherence. However this study suggests that there is much more to adherence sustainability than mere cost of therapy. Depression was also associated with non-adherence suggesting that treatment of depression among HIV-infected patients should be given serious consideration as efforts are made to scale up treatment in resource-limited settings. Otherwise mere provision of drugs without support for other related problems may negate the efforts of scaling up treatment. Other reasons for non-adherence were: lack of transportation money to the clinic, stigma and clinical response to therapy. Type of drug packaging that clearly demarcates a day's dose and time was reported to greatly support adherence. The family treatment model seems to support adherence but further study is needed to assess the long-term impact of this model in resource-limited settings.

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  • 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 (download, 240.1┬áKB)

    Summary: This study looked at the effect on treatment adherence when everyone in a household who is eligible for antiretroviral treatment receives it. The study was conducted among HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Antiretroviral medications are provided at no cost to the patients in this program.We observed high adherence levels with a mean of over 94%. An important finding of this study was that adherence declined over time even when antiretroviral medications were provided at no cost to the patients. Previous studies have shown that cost of therapy was a major predictor of non-adherence. However this study suggests that there is much more to adherence sustainability than mere cost of therapy. Depression was also associated with non-adherence suggesting that treatment of depression among HIV-infected patients should be given serious consideration as efforts are made to scale up treatment in resource-limited settings. Otherwise mere provision of drugs without support for other related problems may negate the efforts of scaling up treatment. Other reasons for non-adherence were: lack of transportation money to the clinic, stigma and clinical response to therapy. Type of drug packaging that clearly demarcates a day's dose and time was reported to greatly support adherence. The family treatment model seems to support adherence but further study is needed to assess the long-term impact of this model in resource-limited settings.

    Source: AIDS and Behavior

    Publication Date: March 20, 2009

    Language: English

    Keywords: Adherence, antiretroviral therapy, Household, MTCT-Plus, Uganda

 

This Community is Archived.

This community is no longer active as of December 2018. Thanks to those who posted here and made this information available to others visiting the site.