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High prevalence of non-adherence to antiretroviral therapy among undisclosed HIV-infected children in Ghana

机译：在加纳未披露的艾滋病毒感染儿童抗逆转录病毒治疗的抗逆转录病毒治疗高患病率

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Adherence to antiretroviral therapy (ART) remains one of the greatest obstacles in pediatric HIV care. We sought to determine the prevalence of adherence to ART among undisclosed HIV-infected children and adolescents in Ghana. We analyzed baseline data from HIV-infected children and adolescents aged 7-18 years old enrolled in the SANKOFA Pediatric HIV disclosure intervention study in Ghana. Antiretroviral medication adherence was measured using caregiver 3-day recall; child 3-day recall; and pharmacy records for antiretroviral time-to-refill. Four hundred and twenty child-caregiver dyads were enrolled from January 2013 to June 2016. The median adherence (interquartile range), as measured by time-to-refill, was 93.2% (68.0%-100.0%). However, only 47.5% of children had = 95% adherence ("good adherence") using time-to-refill data. Children of caregivers who had received secondary or higher level of education versus no school (aOR, 2.90, 95% Confidence Interval, CI 1.29-6.56), p = 0.010) or elementary education only (aOR, 2.20, CI, 1.24-3.88, p = 0.007) were more likely to have "good adherence" (= 95%). In this cohort of children unaware of their HIV positive status, median ART adherence rate was sub-optimal (by World Health Organization definition) while 38% had poor adherence (85%).
机译：坚持抗逆转录病毒治疗（艺术）仍然是儿科艾滋病毒护理中最大的障碍之一。我们试图确定在加纳未披露的艾滋病毒感染的儿童和青少年中遵守艺术的普遍性。我们分析了7-18岁的艾滋病毒感染儿童和青少年的基线数据，纳入加纳的Sankofa儿科艾滋病毒披露干预研究。使用护理人员3天召回测量抗逆转录病毒药物依从性;孩子3天回忆;和药房用于抗逆转录病毒时间到替换的记录。从2013年1月至2016年6月开始招募了四百二十个儿童护理人员。按时间替换量测量的中位粘附（四分位数范围）为93.2％（68.0％-100.0％）。然而，只有47.5％的儿童使用＆ = 95％的遵守（“良好的遵守”）使用时间 - 替换数据。仅收到次要或更高教育水平的照顾者（AOR，2.90,95％的信心区间，CI 1.29-6.56），P = 0.010）或基础教育（AOR，2.20，CI，1.24-3.88， p = 0.007）更可能具有“良好的粘附”（＆ = 95％）。在这种儿童的群体中，没有意识到他们的艾滋病毒阳性地位，中位艺术依从性率是次优（世界卫生组织定义），而38％的粘附性差（＆lt 195％）。

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