As they get older, US children born with HIV are less likely to take the medicine they need to fight the Aids-causing virus, a new study finds.
About 12 000 children, teens and young adults in the United States have had HIV since birth. Antiretroviral therapy (ART) is key to managing the infection and reducing the risk of transmission.
Detectable viral load
In this study, researchers followed 381 of these 8- to 22-year-olds with HIV for an average of 3.3 years.
Rates of nonadherence to antiretroviral therapy rose from 31% in childhood to 50% in young adulthood, and the rates of detectable viral load among the same age groups increased from 16% to 40%.
A detectable viral load indicates that HIV is not being managed by medications.
Sticking to a daily drug regimen can be especially challenging for adolescents and young adults, who are going through physical, cognitive, social and emotional changes, according to researchers from the Harvard T.H. Chan School of Public Health.
"As they approach adulthood, many youth face challenges, such as entering new relationships, managing disclosure of their HIV status, and changing to an adult HIV care provider. Ensuring successful HIV medication adherence before and throughout adolescence is critical," said lead author Deborah Kacanek, a research scientist at Harvard.
Important to talk with youth
Different factors were associated with ART nonadherence in each age group. For example, among 15- to 17-year-olds, those factors were alcohol use, having an unmarried caregiver, indirect exposure to violence, stigma and stressful life events.
At all ages, patients concerned about side effects were less likely to follow their prescription, according to the study, which was published online recently in the journal AIDS.
"We found that the factors that either supported adherence and a suppressed [undetectable] viral load, or made it harder for youth to adhere to treatment, varied depending on their age," Kacanek said in a Harvard news release.
She noted it's important to talk with youth about how to take their medications properly, but the study also highlights the need for caregivers to focus on age-related factors that affect whether they do so.
"Services to help support adherence need to address both the age-related risks and build on the sources of strength and resilience among youth at different stages of development," Kacanek concluded.Image credit: iStock