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09.12.2017 | Original Paper | Ausgabe 3/2018

AIDS and Behavior 3/2018

Association of Adolescent- and Caregiver-Reported Antiretroviral Therapy Adherence with HIV Viral Load Among Perinatally-infected South African Adolescents

AIDS and Behavior > Ausgabe 3/2018
Kirsty Brittain, Nana Akua Asafu-Agyei, Jacqueline Hoare, Linda-Gail Bekker, Helena Rabie, James Nuttall, Paul Roux, Dan J. Stein, Heather J. Zar, Landon Myer
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10461-017-2004-2) contains supplementary material, which is available to authorized users.


Accurate measurement of antiretroviral therapy (ART) adherence remains challenging and there are few data assessing the validity of self-reported adherence among perinatally HIV-infected adolescents. We examined adolescent and caregiver reports of adolescent adherence among perinatally-infected adolescents aged 9–14 years in Cape Town, South Africa, and explored factors that may modify associations between reported adherence and elevated viral load (VL). Among 474 adolescents (median age 12.0 years; median duration of ART use 7.5 years), elevated VL and caregiver- and adolescent-report of missed ART doses were common. Elevated VL was particularly prevalent among older, male adolescents. Low-moderate concordance was observed between caregiver and adolescent report. Among adolescents aged ≥ 12 years, caregiver- and adolescent-reported adherence was associated with elevated VL across most items assessed, but few significant associations were observed among adolescents < 12 years of age. Refined adherence measures and tools to identify adolescents who require adherence interventions are needed in this context.

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