Social ecological predictors of longitudinal HIV treatment adherence in youth with perinatally acquired HIV

Sylvie Naar-King; Grace Montepiedra; Patricia Garvie; Betsy Kammerer; Kathleen Malee; Patricia A. Sirois; Lisa Aaron; Sharon L. Nichols

doi:10.1093/jpepsy/jst017

Social ecological predictors of longitudinal HIV treatment adherence in youth with perinatally acquired HIV

Sylvie Naar-King^*, Grace Montepiedra, Patricia Garvie, Betsy Kammerer, Kathleen Malee, Patricia A. Sirois, Lisa Aaron, Sharon L. Nichols

^*Corresponding author for this work

Psychiatry and Behavioral Sciences

Research output: Contribution to journal › Article › peer-review

35 Scopus citations

Abstract

Objective To apply a social ecological model to explore the psychosocial factors prospectively associated with longitudinal adherence to antiretroviral treatment in youth perinatally infected with HIV. Methods Randomly selected youth, age 8 to <19 years old, completed cognitive testing and psychosocial questionnaires at baseline as part of a multisite protocol (N = 138). A validated caregiver-report measure of adherence was completed at baseline and 24 and 48 weeks after baseline. Results In multivariate analysis, youth awareness of HIV status, caregiver not fully responsible for medications, low caregiver well-being, adolescent perceptions of poor caregiver-youth relations, caregiver perceptions of low social support, and African American ethnicity were associated with nonadherence over 48 weeks. Conclusions Interventions focusing on caregivers and their interactions with the individual youth and extrafamilial system should be prioritized for prevention and treatment efforts to address nonadherence during the transition into adolescents.

Original language	English (US)
Pages (from-to)	664-674
Number of pages	11
Journal	Journal of pediatric psychology
Volume	38
Issue number	6
DOIs	https://doi.org/10.1093/jpepsy/jst017
State	Published - Jul 2013

Funding

Overall support for the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) was provided by the National Institute of Allergy and Infectious Diseases (NIAID) (U01 AI068632), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and the National Institute of Mental Health (NIMH) (AI068632). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This work was supported by the Statistical and Data Analysis Center at Harvard School of Public Health, under the National Institute of Allergy and Infectious Diseases cooperative agreement #5 U01 AI41110 with the Pediatric AIDS Clinical Trials Group (PACTG) and #1 U01 AI068616 with the IMPAACT Group. Support of the sites was provided by the National Institute of Allergy and Infectious Diseases (NIAID) and the NICHD International and Domestic Pediatric and Maternal HIV Clinical Trials Network funded by NICHD (contract number N01-DK-9-001/HHSN267200800001C). The study was funded by the United States National Institute of Allergy and Infectious Diseases and the National Institute of Child Health and Human Development. These institutions were involved in the design, data collection, and conduct of protocol P1042S, but were not involved in the present analysis, the interpretation of the data, the writing of the manuscript, or the decision to submit for publication. Additional funding was provided by the William T. Grant Foundation. This work was supported by the Statistical and Data Analysis Center (SDAC) of the Pediatric AIDS Clinical Trials Group at Harvard School of Public Health, under the National Institute of Allergy and Infectious Diseases cooperative agreement No. 5 01 AI41110.

Keywords

HIV
antiretroviral therapy
children
patient adherence

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Developmental and Educational Psychology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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@article{3b74e1e520a946eeb2e83beafead4faa,

title = "Social ecological predictors of longitudinal HIV treatment adherence in youth with perinatally acquired HIV",

abstract = "Objective To apply a social ecological model to explore the psychosocial factors prospectively associated with longitudinal adherence to antiretroviral treatment in youth perinatally infected with HIV. Methods Randomly selected youth, age 8 to <19 years old, completed cognitive testing and psychosocial questionnaires at baseline as part of a multisite protocol (N = 138). A validated caregiver-report measure of adherence was completed at baseline and 24 and 48 weeks after baseline. Results In multivariate analysis, youth awareness of HIV status, caregiver not fully responsible for medications, low caregiver well-being, adolescent perceptions of poor caregiver-youth relations, caregiver perceptions of low social support, and African American ethnicity were associated with nonadherence over 48 weeks. Conclusions Interventions focusing on caregivers and their interactions with the individual youth and extrafamilial system should be prioritized for prevention and treatment efforts to address nonadherence during the transition into adolescents.",

keywords = "HIV, antiretroviral therapy, children, patient adherence",

author = "Sylvie Naar-King and Grace Montepiedra and Patricia Garvie and Betsy Kammerer and Kathleen Malee and Sirois, {Patricia A.} and Lisa Aaron and Nichols, {Sharon L.}",

note = "Funding Information: Overall support for the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) was provided by the National Institute of Allergy and Infectious Diseases (NIAID) (U01 AI068632), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and the National Institute of Mental Health (NIMH) (AI068632). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This work was supported by the Statistical and Data Analysis Center at Harvard School of Public Health, under the National Institute of Allergy and Infectious Diseases cooperative agreement #5 U01 AI41110 with the Pediatric AIDS Clinical Trials Group (PACTG) and #1 U01 AI068616 with the IMPAACT Group. Support of the sites was provided by the National Institute of Allergy and Infectious Diseases (NIAID) and the NICHD International and Domestic Pediatric and Maternal HIV Clinical Trials Network funded by NICHD (contract number N01-DK-9-001/HHSN267200800001C). The study was funded by the United States National Institute of Allergy and Infectious Diseases and the National Institute of Child Health and Human Development. These institutions were involved in the design, data collection, and conduct of protocol P1042S, but were not involved in the present analysis, the interpretation of the data, the writing of the manuscript, or the decision to submit for publication. Additional funding was provided by the William T. Grant Foundation. This work was supported by the Statistical and Data Analysis Center (SDAC) of the Pediatric AIDS Clinical Trials Group at Harvard School of Public Health, under the National Institute of Allergy and Infectious Diseases cooperative agreement No. 5 01 AI41110.",

year = "2013",

month = jul,

doi = "10.1093/jpepsy/jst017",

language = "English (US)",

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T1 - Social ecological predictors of longitudinal HIV treatment adherence in youth with perinatally acquired HIV

AU - Naar-King, Sylvie

AU - Montepiedra, Grace

AU - Garvie, Patricia

AU - Kammerer, Betsy

AU - Malee, Kathleen

AU - Sirois, Patricia A.

AU - Aaron, Lisa

AU - Nichols, Sharon L.

N1 - Funding Information: Overall support for the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) was provided by the National Institute of Allergy and Infectious Diseases (NIAID) (U01 AI068632), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and the National Institute of Mental Health (NIMH) (AI068632). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This work was supported by the Statistical and Data Analysis Center at Harvard School of Public Health, under the National Institute of Allergy and Infectious Diseases cooperative agreement #5 U01 AI41110 with the Pediatric AIDS Clinical Trials Group (PACTG) and #1 U01 AI068616 with the IMPAACT Group. Support of the sites was provided by the National Institute of Allergy and Infectious Diseases (NIAID) and the NICHD International and Domestic Pediatric and Maternal HIV Clinical Trials Network funded by NICHD (contract number N01-DK-9-001/HHSN267200800001C). The study was funded by the United States National Institute of Allergy and Infectious Diseases and the National Institute of Child Health and Human Development. These institutions were involved in the design, data collection, and conduct of protocol P1042S, but were not involved in the present analysis, the interpretation of the data, the writing of the manuscript, or the decision to submit for publication. Additional funding was provided by the William T. Grant Foundation. This work was supported by the Statistical and Data Analysis Center (SDAC) of the Pediatric AIDS Clinical Trials Group at Harvard School of Public Health, under the National Institute of Allergy and Infectious Diseases cooperative agreement No. 5 01 AI41110.

PY - 2013/7

Y1 - 2013/7

N2 - Objective To apply a social ecological model to explore the psychosocial factors prospectively associated with longitudinal adherence to antiretroviral treatment in youth perinatally infected with HIV. Methods Randomly selected youth, age 8 to <19 years old, completed cognitive testing and psychosocial questionnaires at baseline as part of a multisite protocol (N = 138). A validated caregiver-report measure of adherence was completed at baseline and 24 and 48 weeks after baseline. Results In multivariate analysis, youth awareness of HIV status, caregiver not fully responsible for medications, low caregiver well-being, adolescent perceptions of poor caregiver-youth relations, caregiver perceptions of low social support, and African American ethnicity were associated with nonadherence over 48 weeks. Conclusions Interventions focusing on caregivers and their interactions with the individual youth and extrafamilial system should be prioritized for prevention and treatment efforts to address nonadherence during the transition into adolescents.

AB - Objective To apply a social ecological model to explore the psychosocial factors prospectively associated with longitudinal adherence to antiretroviral treatment in youth perinatally infected with HIV. Methods Randomly selected youth, age 8 to <19 years old, completed cognitive testing and psychosocial questionnaires at baseline as part of a multisite protocol (N = 138). A validated caregiver-report measure of adherence was completed at baseline and 24 and 48 weeks after baseline. Results In multivariate analysis, youth awareness of HIV status, caregiver not fully responsible for medications, low caregiver well-being, adolescent perceptions of poor caregiver-youth relations, caregiver perceptions of low social support, and African American ethnicity were associated with nonadherence over 48 weeks. Conclusions Interventions focusing on caregivers and their interactions with the individual youth and extrafamilial system should be prioritized for prevention and treatment efforts to address nonadherence during the transition into adolescents.

KW - HIV

KW - antiretroviral therapy

KW - children

KW - patient adherence

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SP - 664

EP - 674

JO - Journal of pediatric psychology

JF - Journal of pediatric psychology

IS - 6

ER -

Social ecological predictors of longitudinal HIV treatment adherence in youth with perinatally acquired HIV

Abstract

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Keywords

ASJC Scopus subject areas

UN SDGs

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