Adherence status of HIV infected children at ART centre of South India

Narayan V. Nayak, Abhishek Prayag


Background: Adherence to antiretroviral therapy (ART) is a principal determinant of virologic suppression. A variety of factors: including formulation of medicine, dose frequencing, drug toxicities, child’s age, as well as psychosocial, behavioral, and sociodemographic characteristics of children and caregivers have been associated with nonadherence. Still no consistent predictors of either good or poor adherence in children have been consistently identified.

Methods: Data was collected from the ART Centre. Record based data from the year 2008 to 2018 April of pediatric age group i.e. from 0-18 years. All the cases registered at the center whose data were available were included for the study. Adherence was assessed calculating the average monthly consumption of ARV assessed by pill count as per NACO guidelines.

Results: At the ART Centre, 139 (73.5%) were on treatment i.e. 75.7% of boys registered and 70.9% of registered girls. Average monthly adherence and treatment interruptions among the 73 children alive on ART, majority i.e. 90.4% were on good adherence with 8.2% on less than 80% adherence.

Conclusions: Overall a good adherence indicates efficient functioning of the programme and determined efforts from the ART Centre.


Adherence, ART, Children, South India

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Childline India Foundation. Children Living with HIV/AIDS. Child line India Foundation Available at Accessed 4th June 2018.

National AIDS Control Organization. Annual report of NACO 2016-17. Available at

Towards Universal Access. Scaling up Priority HIV/AIDS Interventions in the Health Sector. Progress Report 2011. Geneva: WHO; 2011.

De Cock KM, Fowler MG, Mercier E, de Vincenzi I, Saba J, Hoff E, et al. Prevention of mother‑to‑child HIV transmission in resource‑poor countries: Translating research into policy and practice. JAMA. 2000;283:1175‑82.

MacDonell KK, Jacques-Tiura AJ, Naar S, Fernandez MI, Team ATNP. Predictors of self-reported adherence to antiretroviral medication in a multisite study of ethnic and racial minority HIV positive youth. J Pediatr Psychol. 2016;41(4):419-28.

Gray ME, Nieburg P, Dillingham R. Pediatric Human immunodeficiency virus continuum of care: a concise review of evidence-based practice. Paediatr Clin North Am. 2017;64(4):879-91.

Schlatter AF, Deathe AR, Vreeman RC. The need for pediatric formulations to treat children with HIV. AIDS Res Treat. 2016;2016:1654938.

Tan IL, Smith BR, von Geldern G, Mateen FJ, McArthur JC. HIV associated opportunistic infections of the CNS. Lancet Neurol. 2012;11(7):605-17.

Poudel PRP, Chitlangia M, Chaudhary S. Profile of HIV infected children: a hospital-based study at Eastern Nepal Asian. Pacific J Trop Dis. 2014;4(3):169-75.

Madhivanan PMS, Kumarasamy N, Yepthomi T, Venkatesan C, Lambert JS. Clinical manifestations of HIV infected children. Indian J Pediatr. 2003;70(8):615-20.

Gomber SKJ, Chandra J, Anand R. Profile of HIV infected children from Delhi and their response to antiretroviral treatment. Indian Pediatr. 2011;48:703.

Seth A, Gupta R, Chandra J, Maheshwari A, Kumar P, Aneja S. Adherence to antiretroviral therapy and its determinants in children with HIV infection: experience from paediatric centre of excellence in HIV Care in North India. AIDS Care. 2014;26(7):865-71.

Mehta K, Ekstrand M, Heylen E, Sanjeeva G, Shet A. Adherence to antiretroviral therapy among children living with HIV in South India. AIDS Behavior. 2016;20(5):1076-83.

Haberer J, Mellins C. Pediatric adherence to HIV antiretroviral therapy. Curr HIV/AIDS Rep. 2009;6(4):194-200.

Shubber Z, Mills EJ, Nachega JB. Patient-reported barriers to adherence to antiretroviral therapy: a systematic review and meta-analysis. PLoS Med. 2016;13(11):e1002183.

Clay PG, Nag S, Graham CM, Narayanan S. Meta-analysis of studies comparing single and multitablet fixed dose combination HIV treatment regimens. Medicine (Baltimore). 2015;94(42):e1677.

Sharma M, Singh RR, Laishram P, Kumar B, Nanao H, Sharma C, et al. Access, adherence, quality and impact of ARV provision to current and ex-injecting drug users in Manipur (India): an initial assessment. Int J Drug Policy. 2007;18:319-25.

Doku P N. Parental HIV/AIDS status and death, and children's psychological wellbeing. Int J Mental Health Sys. 2009;3:26.