(RxWiki News) Children with HIV can live longer lives than ever with the range of anti-retroviral drugs available. But the drugs only work if they take them regularly and on time.
A recent study about HIV-positive children found that a significant number of them are not taking all their medications as prescribed by their doctors, but the reasons vary.
"Yes, you should take all the drugs your doctor prescribes."
Ashley Buchanan, MS, of the Center for Bio-statistics in AIDS Research at the Harvard School of Public Health, and colleagues sought to find out the reasons HIV-positive children may not adhere to their medication regimen.
They gave 120 children and their caregivers a questionnaire with questions about 19 possible reasons the children might not stick to their anti-retroviral therapy program.
About half of the children were African American and half were boys. The average age of the children was 12. Less than half (42 percent) of the kids' primary caregivers were their parents.
Among the 120 pairs of children and caregivers, 66 of the kids and 73 of the caregivers reported that the child missed a dose of medication in the past month. Nearly half (49 percent) were considered not adhering to their medication because they took less than 90 percent of their prescribed medications.
The most common reason given for not taking medication was that the child or caregiver simply forgot.
Other reasons given were the "taste" of the medications, the "child was away from home," the "child refused," and the "child felt good." These were reported in varying amounts without many clear patterns.
For the majority of the children (52 percent), the caregivers were fully responsible for tracking and giving the medications to the children.
A smaller number of the children (12 percent) were fully responsible for their medications, and 36 percent of the children shared the responsibility with their caregiver.
The children who knew they were HIV-positive were more likely to attribute not taking the medication to logistical reasons - like scheduling difficulties, not having refills, sleeping through the dose time or not being home - rather than emotional or other reasons.
The children whose parents were their primary caregivers were more likely to explain the missed medications based on the child's fear that others might notice the medications or on problems with the regimen itself.
Problems with the regimen included not being able to keep down the medications, having too much medication to take, trying to avoid the side effects, difficulty taking the medication as it was directed or experiencing toxicity from the meds.
The researchers concluded that there was too little agreement between the children and the caregivers about most of the barriers to taking medication, which means the children and caregivers see their medication problems differently.
"The findings suggest a need for interventions that involve both child and caregiver in the tasks of remembering when to administer the child's medications, sustaining adherence and appropriately transitioning medication responsibility to the youth," they wrote.
The study appeared online April 16 and was published in the May issue in the journal Pediatrics. The research was funded by the National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Mental Health and the National Institutes of Health.
The authors declared no conflicts of interest.
