Study finds children born with HIV are less likely to adhere to medications as they get older

According to a new study by researchers at Harvard TH, children born with HIV in the United States were less likely to adhere to their medications at the age of pre-adolescence to adolescence and early childhood. early adulthood. Chan School of Public Health. In addition, the prevalence of detectable viral load – an indication that the virus is not managed by medication and a factor often badociated with non-compliance – has also increased with age.

The study is one of the first to examine why different age groups stop adhering to treatment (non-adherence). Although the factors related to non-compliance vary by age group, young people concerned about the side effects of drugs were less likely to be adherents at most ages.

As we approach adulthood, many young people face challenges such as building new relationships, managing disclosure of their HIV status, and turning into a caregiver. for adult HIV. Ensuring adherence to HIV before and during adolescence is essential. We found that factors that favored adherence to treatment and suppressed viral load (undetectable) or made it more difficult for young people to adhere to treatment, depending on their age. "

Deborah Kacanek, Principal Writer, Researcher, Department of Biostatistics, Harvard Chan School

The study was published online before printing in AIDS.

In the United States, approximately 12,000 children, adolescents and young adults are living with HIV acquired at the perinatal stage, which means they have been living with HIV since birth. Globally, 1.8 million adolescents live with HIV. Adherence to antiretroviral therapy regimens (ART) is essential to manage the disease and reduce the risk of transmission. Adhering to a daily medical regimen, however, is particularly difficult for teens and young adults, who undergo a range of physical, cognitive, social and emotional changes.

Membership may be more complicated for young people who are growing up with perinatal HIV, whose lifelong experience with HIV, stigma and multiple antiretroviral drugs may be problematic for achieve viral suppression different from that of young people who contract HIV later in life.

In order to better understand these challenges and the reasons why young people may not be observing their medications, researchers tracked 381 young people with HIV acquired during the perinatal period for an average of 3.3 years. Youth participated in the Pediatric HIV / AIDS Cohort Study, which tracks children and youth born with HIV or exposed to HIV at birth to determine the impact of HIV for life and the long-term safety of schemas. therapeutic antiretrovirals.

Preadolescents, adolescents, and young adults in the study were between 8 and 22 years old and had been recruited from 15 different clinical sites in the United States, including Puerto Rico. As part of the study, researchers examined the results of blood tests that measured viral load, as well as almost 1,200 compliance badessments in which study participants or their caregivers reported missed doses of medication in the previous seven days.

Researchers found that from pre-adolescence to early adulthood, the prevalence of non-adherence increased from 31% to 50%. In addition, the prevalence of detectable viral load in the same age groups increased from 16% to 40%.

For each age group, different factors were badociated with non-compliance. For example, in the middle of adolescence (15-17 years), alcohol consumption, having a single caregiver, indirect exposure to violence, the stigma and stressful life events were all badociated with non-compliance.

"It's important to discuss with young people how to take their medications properly, but our study highlights the need for those who care about these youngsters to also focus on the age-related factors that can affect compliance, "Kacanek said. "Services to help promote membership need to address both age-related risks and the sources of strength and resilience of young people at different stages of development. "