Journal article
Nonadherence and unsuppressed viral load across adolescence among US youth with perinatally acquired HIV
AIDS (London), v 33(12), pp 1923-1934
01 Oct 2019
PMID: 31274538
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective: To identify factors associated with nonadherence and unsuppressed viral load across adolescence among youth with perinatally acquired HIV. Design: Longitudinal study at 15 US clinical sites. Methods: Self-reported antiretroviral medication nonadherence (any missed dose, past week) and unsuppressed viral load (HIV RNA > 400 copies/ml) were assessed annually. Individual, caregiver, social, and structural factors associated with nonadherence and unsuppressed viral load were identified by age (years): 8-11 (preadolescence), 12-14 (early adolescence), 15-17 (middle adolescence), and 18-22 (late adolescence/young adulthood), utilizing multivariable generalized linear mixed effects models. Results: During a median 3.3-year follow-up, 381 youth with perinatally acquired HIV contributed viral load measurements and 379 completed 1190 adherence evaluations. From preadolescence to late adolescence/young adulthood, prevalence of nonadherence increased from 31 to 50% (P < 0.001); prevalence of unsuppressed viral load increased from 16 to 40% (P < 0.001). In adjusted analyses, in pre, middle, and late adolescence/young adulthood, perceived antiretroviral side effects were associated with nonadherence. Additional factors associated with nonadherence included: in preadolescence, using a buddy system (as an adherence reminder); in early adolescence, identifying as black, using buddy system; in middle adolescence, CD4(+)% less than 15%, unmarried caregiver, indirect exposure to violence, stigma/fear of inadvertent disclosure, stressful life events. Associations with unsuppressed viral load included: in early adolescence, youth unawareness of HIV status, lower income; in middle adolescence, perceived antiretroviral side effects, lower income; in late adolescence/young adulthood, distressing physical symptoms, and perceived antiretroviral side effects. Conclusion: Prevalence of nonadherence and unsuppressed viral load increased with age. Associated factors varied across adolescence. Recognition of age-specific factors is important when considering strategies to support adherence.
Metrics
Details
- Title
- Nonadherence and unsuppressed viral load across adolescence among US youth with perinatally acquired HIV
- Creators
- Deborah Kacanek - Cancer Research And BiostatisticsYanling Huo - Cancer Research And BiostatisticsKathleen Malee - Northwestern UniversityClaude A. Mellins - Columbia University Irving Medical CenterRenee Smith - University of Illinois ChicagoPatricia A. Garvie - Children's Diagnostic & Treatment CenterKatherine Tassiopoulos - Harvard UniversitySonia Lee - Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentClaire A. Berman - Harvard UniversityMary Paul - Baylor College of MedicineAna Puga - Childrens Diagnost & Treatment Ctr, Res Dept, Ft Lauderdale, FL USASusannah Allison - Office of AIDS ResearchEllen Chadwick - Ann & Robert H Lurie Childrens Hosp Chicago, Chicago, IL 60611 USAMargaret Ann Sanders - Ann & Robert H Lurie Childrens Hosp Chicago, Chicago, IL 60611 USAYoonsun Pyun - Ann & Robert H Lurie Childrens Hosp Chicago, Chicago, IL 60611 USAWilliam Shearer - College Station Medical CenterNorma Cooper - College Station Medical CenterChivon McMullen-Jackson - College Station Medical CenterMandi Speer - College Station Medical CenterLynette Harris - College Station Medical CenterMurli Purswani - Bronx-Lebanon Hospital CenterMahboobullah Mirza Baig - Bronx-Lebanon Hospital CenterAlma Villegas - Bronx-Lebanon Hospital CenterLisa Gaye-Robinson Sandra Navarro - Childrens Diagnost & Treatment Ctr, Ft Lauderdale, FL USASandra K. Burchett - Boston Childrens Hosp, Boston, MA USAMichelle E. Anderson - Boston Childrens Hosp, Boston, MA USAAdam R. Cassidy - Boston Childrens Hosp, Boston, MA USAAndrew Wiznia - College Station Medical CenterMarlene Burey - College Station Medical CenterRay Shaw - College Station Medical CenterRaphaelle Auguste - College Station Medical CenterArry Dieudonne - Rutgers New Jersey Med Sch, Newark, NJ USALinda Bettica - Rutgers New Jersey Med Sch, Newark, NJ USAJuliette Johnson - Rutgers New Jersey Med Sch, Newark, NJ USAKaren Surowiec - Rutgers New Jersey Med Sch, Newark, NJ USAJanet S. Chen - St Christophers Hosp Children, Philadelphia, PA 19133 USAMaria Garcia Bulkley - St Christophers Hosp Children, Philadelphia, PA 19133 USATaesha White - St Christophers Hosp Children, Philadelphia, PA 19133 USAMitzie Grant - St Christophers Hosp Children, Philadelphia, PA 19133 USAKatherine Knapp - St Jude Childrens Res Hosp, 332 N Lauderdale St, Memphis, TN 38105 USAKim Allison - St Jude Childrens Res Hosp, 332 N Lauderdale St, Memphis, TN 38105 USAMegan Wilkins - St Jude Childrens Res Hosp, 332 N Lauderdale St, Memphis, TN 38105 USAJamie Russell-Bell - St Jude Childrens Res Hosp, 332 N Lauderdale St, Memphis, TN 38105 USAMidnela Acevedo-Flores - San Juan Hosp, Dept Pediat, San Juan, PR USAHeida Rios - San Juan Hosp, Dept Pediat, San Juan, PR USAVivian Olivera - San Juan Hosp, Dept Pediat, San Juan, PR USAMargarita Silio - Tulane UniversityMedea Gabriel - Tulane UniversityPatricia Sirois - Tulane UniversityStephen A. Spector - Univ Calif San Diego, San Diego, CA 92103 USAMegan Loughran - Univ Calif San Diego, San Diego, CA 92103 USAVeronica Figueroa - Univ Calif San Diego, San Diego, CA 92103 USASharon Nichols - Univ Calif San Diego, San Diego, CA 92103 USAElizabeth McFarland - University of Colorado DenverEmily Barr - University of Colorado DenverCarrie Chambers - University of Colorado DenverMary Glidden - University of Colorado DenverGwendolyn Scott - University of MiamiGrace Alvarez - University of MiamiJuan Caffroni - University of MiamiAnai Cuadra - University of MiamiPediat HIV AIDS Cohort Study
- Publication Details
- AIDS (London), v 33(12), pp 1923-1934
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 12
- Grant note
- National Institute of Allergy and Infectious Diseases (NIAID); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) National Institute on Alcohol Abuse and Alcoholism; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Alcohol Abuse & Alcoholism (NIAAA) National Institute of Mental Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Office of AIDS Research; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA National Institute on Alcohol Abuse and Alcoholism (NIAAA); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Alcohol Abuse & Alcoholism (NIAAA) National Institute of Mental Health (NIMH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) National Institute of Neurological Disorders and Stroke (NINDS); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) National Institute on Deafness and Other Communication Disorders (NIDCD); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Deafness & Other Communication Disorders (NIDCD) National Institute on Drug Abuse; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Drug Abuse (NIDA) National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) HD052104 / Tulane University School of Medicine National Institute of Neurological Disorders and Stroke; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) Office of AIDS Research (OAR); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA HD052102 / Harvard T.H. Chan School of Public Health Eunice Kennedy Shriver National Institute of Child Health and Human Development; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) National Institute of Dental and Craniofacial Research; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Dental & Craniofacial Research (NIDCR) National Institute of Dental and Craniofacial Research (NIDCR); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Dental & Craniofacial Research (NIDCR) National Institute of Allergy and Infectious Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) National Institute on Deafness and Other Communication Disorders; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Deafness & Other Communication Disorders (NIDCD) National Institute on Drug Abuse (NIDA); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Drug Abuse (NIDA) National Heart Lung and Blood Institute (NHLBI); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Psychiatry; Nursing (Undergraduate); Pediatrics
- Web of Science ID
- WOS:000507295000012
- Scopus ID
- 2-s2.0-85071784819
- Other Identifier
- 991021463545704721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Immunology
- Infectious Diseases
- Virology