ArticlePloS one2018
Adherence to antiretroviral therapy in a clinical cohort of HIV-infected children in East Africa.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Pooled it
- The Effect of Depression on the Pathways Between an Economic Strengthening Intervention and ART Adherence in Youths with HIV: Findings from a Moderated Mediation Model of the Suubi + Adherence Cluster-Randomized Study.Prevention science : the official journal of the Society for Prevention Research · 2025Trial
- Trial
- Challenges with drug management of children and adolescents living with human immunodeficiency virus on antiretroviral therapy: A narrative review.African journal of primary health care & family medicine · 2026Review
- Under the Influence: Alcohol, Substance Use and Treatment Adherence in Youth Living with HIV in the Global Adolescent and Young Adult Network of IeDEA (AYANI) Cohort.AIDS and behavior · 2026Article
- Age-Related Variations in Clinical and Biochemical Profiles of People Living With HIV.AIDS research and treatment · 2026Article
- Article
- Correlates of virological non-suppression among children and adolescents aged 5-19 years on Dolutegravir-based regimens attending Gulu regional referral hospital, Northern Uganda: a mixed methods cross-sectional study.BMC infectious diseases · 2025Article
- Article
- Factors associated with non-adherence to antiretroviral therapy among adolescents in Oshikoto Region, Namibia.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
- Patient related factors associated with antiretroviral therapy defaulting among the youth accessing HIV care services in Mzimba, Malawi.PLOS global public health · 2025Article
- Barriers to viral suppression in children aged 9 years or younger on dolutegravir-based antiretroviral therapy in Malawi, a mixed-methods study.PLOS global public health · 2025Article
- The effect of family support on self-reported adherence to ART among adolescents perinatally infected with HIV in Uganda: A mediation analysis.Journal of adolescence · 2023Article
- Longitudinal impacts of the COVID-19 pandemic on adolescents living with HIV in New York City.AIDS care · 2023Article
- The effect of substance uses on antiretroviral treatment adherence in primary health care.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2023Article
- Proportion of Attrition and Associated Factors Among Children Receiving Antiretroviral Therapy in Public Health Facilities, Southern Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Children's Adherence to Antiretroviral Therapy and Associated Factors: Multicenter Cross-Sectional Study.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Predictors of Suboptimal Adherence Among Children on Antiretroviral Therapy in Southern Ethiopia: A Multicenter Retrospective Follow-Up Study.International journal of public health · 2023Article
- Factors associated with HIV viral suppression among adolescents in Kabale district, South Western Uganda.PloS one · 2022Article
- Factors associated with readiness to start antiretroviral therapy (ART) among young people (15-24 years) at four HIV clinics in Mulago Hospital, Uganda.African health sciences · 2021Article
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 3 countries.
Funding
Abstract
objectiveTo describe antiretroviral therapy (ART) adherence and associated factors for a large HIV-infected pediatric cohort followed by sites of the East Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) consortium.
methodsThis study utilized prospectively collected clinical data from HIV-infected children less than 13 years of age who initiated ART within 4 clinical care programs (with 26 clinical sites) in Kenya, Uganda, and Tanzania and were followed for up to 6 years. Programs used one of 3 adherence measures, including 7-day quantitative recall, 7-day categorical recall, and clinician pill assessments. We fit a hierarchical, three-level, logistic-regression model to examine adherence, with observations nested within patient, and patients within the 26 sites providing pediatric HIV data to this analysis.
resultsIn East Africa, 3,304 children, 52.0% male, were enrolled in care and were subsequently observed for a median of 92 weeks (inter-quartile range [IQR] 50.3-145.0 weeks). Median age at ART initiation was 5.5 years ([IQR] 3.0-8.5 years). "Good" adherence, as reported by each clinic's measures, was extremely high, remaining on average above 90% throughout all years of follow-up. Longer time on ART was associated with higher adherence (adjusted Odds Ratio-aOR-per log-transformed week on ART: 1.095, 95% Confidence Interval-CI-[1.052-1.150].) Patients enrolled in higher-volume programs exhibited higher rates of clinician-assessed adherence (aOR per log-500 patients: 1.174, 95% CI [1.108-1.245]). Significant site-level variability in reported adherence was observed (0.28), with even higher variability among patients (0.71). In a sub-analysis, being an orphan at the start of ART was strongly associated with lower ART adherence rates (aOR: 0.919, 95% CI [0.864-0.976]).
conclusionsSelf-reported adherence remained high over a median of 1.8 years in HIV care, but varied according to patient-level and site-level factors. Consistent adherence monitoring with validated measures and attention to vulnerable groups is recommended.
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