Paediatric ART Adherence in South Africa: A Comprehensive Analysis

Sabine L. van Elsland*, Remco P.H. Peters, Nelis Grobbelaar, Patiswa Ketelo, Maarten O. Kok, Mark F. Cotton, A. Marceline van Furth

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)
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Adherence to antiretroviral therapy (ART) remains a challenge for HIV-infected children. In this cross-sectional study, we used structured interview-administered questionnaires and medical records to measure adherence levels and factors associated with adherence and viral suppression. We included 195 South African children aged 2.1–12.9 on ART. Adherence levels ranged between 20.5% (pill count) and 89.1% (self-report). Boys were less adherent according to self-report, girls were less adherent according to pill count. Caregivers ensured medication was taken when the condition directly affected daily life. Well-functioning families and families with high SES provide a context supportive of adherence. Non-disclosure and difficulties administering medication negatively affected adherence and viral suppression. This study shows challenging levels of adherence impacting directly on viral suppression in a South African paediatric HIV program. Gender roles, non-disclosure and difficulty administering medication may undermine adherence and should be taken into account for clinical guidelines, policy design and inform strategies.

Original languageEnglish
Pages (from-to)475-488
Number of pages14
JournalAIDS and Behavior
Issue number2
Publication statusPublished - 27 Jul 2018

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© 2018, Springer Science+Business Media, LLC, part of Springer Nature.


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