Electronic Antiretroviral Therapy Adherence Monitors and Associated Interventions Improve Adolescent–Caregiver Relationships and Self-Efficacy Among Adolescents and Young Adults with HIV in Uganda.

Many adolescents and young adults with HIV (AYWH) struggle with antiretroviral therapy (ART) adherence and experience poorer outcomes than adults. Relevant factors include forgetfulness and poor self-efficacy related to their evolving neurobiology. We qualitatively explored experiences of AYWH–careg...

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Publicado en:AIDS Patient Care & STDs Vol. 37; no. 10; pp. 489 - 495
Autores principales: Adong, Julian, Asiimwe, Stephen, Nansera, Denis, Muyindike, Winnie, Tumuhairwe, John B., Baijuka, Robert, Tindimwebwa, Edna, Garrison, Lindsey E., Haberer, Jessica E.
Formato: clinical trial research Journal Article
Publicado: Mary Ann Liebert, Inc. Oct2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2023
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      pub: Mary Ann Liebert, Inc.
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        10.1089/apc.2023.0164
        173113266
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        atl: Electronic Antiretroviral Therapy Adherence Monitors and Associated Interventions Improve Adolescent–Caregiver Relationships and Self-Efficacy Among Adolescents and Young Adults with HIV in Uganda.
      aug:
        au:
          Adong, Julian
          Asiimwe, Stephen
          Nansera, Denis
          Muyindike, Winnie
          Tumuhairwe, John B.
          Baijuka, Robert
          Tindimwebwa, Edna
          Garrison, Lindsey E.
          Haberer, Jessica E.
        affil: Mbarara University of Science and Technology, Departments of Pediatrics and Internal Medicine, Faculty of Medicine, Mbarara, Uganda.
      sug:
        subj:
          HIV-Positive Persons In Adolescence
          Caregivers
          Interpersonal Relations Evaluation
          Self-Efficacy In Adolescence
          Medication Compliance Evaluation
          Anti-Retroviral Agents Therapeutic Use
          HIV Infections Drug Therapy
          Treatment Outcomes
          Human
          Qualitative Studies
          Clinical Trials
          Uganda
          Male
          Female
          Adolescence
          Young Adult
          Adult
          Interviews
          Content Analysis
          Descriptive Statistics
          Implementation Science
          Drug Monitoring
          Funding Source
          Adolescent: 13-18 years
          Adult: 19-44 years
          Male
          Female
      ab: Many adolescents and young adults with HIV (AYWH) struggle with antiretroviral therapy (ART) adherence and experience poorer outcomes than adults. Relevant factors include forgetfulness and poor self-efficacy related to their evolving neurobiology. We qualitatively explored experiences of AYWH–caregivers dyads using real-time ART adherence monitors and associated reminder functions in the home setting. As part of an implementation science-oriented study, AYWH used the Wisepill adherence monitor for 3 months. AYWH could also opt for short message service (SMS) self-reminders, a self-selected social supporter for delayed or missed doses, or an alarm reminder. We conducted in-depth interviews with randomly selected AYWH–caregiver dyads regarding their experience using the monitor. Qualitative data were analyzed using inductive content analysis. We completed 15 AYWH–caregiver dyad interviews. Of the AYWH, 67% were female, mean age was 16 years, 56% lived with their biological mother, and 86% were virologically suppressed. AYWH and their caregivers generally found the adherence monitors acceptable, though some had privacy concerns. AYWH felt the monitors helped them take charge of their medication, largely through the real-time alarm and SMS reminders; this took the burden of adherence reminders away from the caregivers, improving strained AYWH–caregiver relationships. Two adolescents reported rebound poor adherence after monitor withdrawal. ART adherence monitors and associated tools were largely acceptable to AYWH and their caregivers in home settings. The intervention helped improve AYWH self-efficacy and alleviated burden from some AYWH–caregiver relationships. Rebound poor adherence suggests the need for on-going support and/or other means to achieve intrinsic mechanisms for sustained adherence. Clinical Trial Registration number: NCT03825952.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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