Challenges and perspectives of compliance with pediatric antiretroviral therapy in Sub-Saharan Africa

Med Mal Infect. 2017 Dec;47(8):511-518. doi: 10.1016/j.medmal.2017.07.006. Epub 2017 Sep 22.

Abstract

More than 3 million children aged less than 15years are infected with HIV worldwide, mainly in Sub-Saharan Africa. The survival of HIV-infected children depends on their access to antiretroviral therapy whose success mainly depends on a good life-long compliance with antiretroviral therapy. Given its complexity and specificity, assessment and monitoring of pediatric compliance with antiretroviral therapy is a major challenge. There is no consensus on a gold standard for monitoring compliance with antiretroviral therapy. Compliance is also influenced by many factors related to the child, the caregiver, the healthcare staff, the healthcare system, and antiretroviral drugs. This review aimed to assess scientific knowledge on pediatric compliance with antiretroviral therapy in Sub-Saharan Africa, and to identify areas for future interventions to improve compliance. Good compliance is essential to achieve the "90% coverage of children on antiretroviral therapy" gold standard of the World Health Organization, and to eliminate HIV infection by 2030.

Keywords: Africa; Afrique; Compliance; HIV; Observance thérapeutique; Pediatric antiretroviral therapy; Traitement antirétroviral pédiatrique; VIH.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Africa South of the Sahara / epidemiology
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / analysis
  • Anti-HIV Agents / blood
  • Anti-HIV Agents / therapeutic use*
  • Attitude to Health
  • Caregivers
  • Child
  • Child, Preschool
  • Community Health Centers / supply & distribution
  • Drug Therapy, Combination
  • Family
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • Hair / chemistry
  • Humans
  • Infant
  • Male
  • Medication Adherence* / psychology
  • Medication Adherence* / statistics & numerical data
  • Socioeconomic Factors
  • Surveys and Questionnaires

Substances

  • Anti-HIV Agents