Longitudinal antiretroviral adherence in HIV+ Ugandan parents and their children initiating HAART in the MTCT-plus family treatment model: Role of depression in declining adherence over time

Jayne Byakika-Tusiime, Johanna Crane, Jessica H. Oyugi, Kathleen Ragland, Annet Kawuma, Philippa Musoke, David R. Bangsberg

Research output: Contribution to journalArticle

111 Scopus citations

Abstract

We conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.

Original languageEnglish (US)
Pages (from-to)S82-S91
JournalAIDS and Behavior
Volume13
Issue numberSUPPL. 1
DOIs
StatePublished - Jun 2009

Keywords

  • Adherence
  • Antiretroviral therapy
  • Household
  • MTCT-Plus
  • Uganda

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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