Analysis of the social and psychosocial factors associated with adherence to antiretroviral therapy in adolescents with perinatal HIV-1 infection in Panama from a gender perspective

ABSTRACT

Adherence is vital for an effective antiretroviral treatment. This cross-sectional study explored social and psychosocial factors associated with adherence among adolescents with perinatal human immunodeficiency virus type 1 infection in Panama from a gender perspective. A questionnaire developed for the study was applied to 38 adolescent patients (20 female, 18 male; median age, 14 years). Thirty-two patients (86%; one missing response) still depended on an adult to remember taking their medication, among whom 28 relied on a female relative. Although 18 (47%) patients reported to become ill no more than once a year, only 10 (26%) patients showed an undetectable viral load, and 4 (11%) patients showed no CD4 suppression. Seventeen (45%) patients recalled correctly their medication. During the week prior to the interview, 26 patients (68%) reported that they had missed at least one dose. When asked the reason for missing a dose, 23 out of 34 (68%; 4 missing responses) patients responded, “I forgot”. Female patients gave more excuses for missing doses (mean ± SD number of excuses per female, 2.4 ± 2; per male, 1.2 ± 1; p = .02), while more male than female patients described an action plan if they ran out of medication (13 vs. 8; p = .05). Educational programs involving patients and also family members are warranted to improve adherence.

KEYWORDS:

• Adolescents
• retroviral therapy
• adherence
• social factors
• psychosocial factors

Acknowledgements

The authors thank Rommel Jáuregui and Carlos Pavel Smith for their valuable input during the development of this project, and acknowledge the unconditional support provided by the AID for AIDS team to our Antiretroviral Pediatric Clinic. The authors also thank ONUSIDA, UNICEF, UNFPA, SENACYT, and AID FOR AIDS for believing in this project and making it possible. Writing assistance was provided by Dr Michelle Belanger, Dr Valeria Marcos, and Dr Keyra Martinez Dunn from TopMed Communications, Panama City, Panama.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by ONUSIDA and UNICEF.