Lower Optimal Treatment Adherence Among Youth Living With HIV in a Universal Health Care Setting Where ART Is Available at No Cost.
Adherence
Canada
HIV
Treatment
Youth
Journal
The Journal of adolescent health : official publication of the Society for Adolescent Medicine
ISSN: 1879-1972
Titre abrégé: J Adolesc Health
Pays: United States
ID NLM: 9102136
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
31
05
2018
revised:
01
10
2018
accepted:
02
10
2018
pubmed:
14
12
2018
medline:
25
7
2020
entrez:
15
12
2018
Statut:
ppublish
Résumé
We assessed differences in optimal adherence between youth (aged 15-29 years) and adults (aged ≥30 years) enrolled in the British Columbia Centre for Excellence in HIV/AIDS Drug Treatment Program from 2010 to 2016. Population-level clinical data were used to compare optimal antiretroviral therapy adherence (≥95%), based on pharmacy refill data, among youth and adults. Unadjusted and adjusted generalized estimating estimates were performed to examine the independent relationship between time-dependent age categories and optimal adherence, adjusting for confounders. Factors associated with optimal adherence among youth were examined. Data for 7,485 individuals living with HIV were included. Median follow-up was 7 years (Q1-Q3: 4-7). Over the study period, the number of individuals categorized as "youth" ranged from 820 in 2010 to 291 in 2016. Multivariable models found youth living with HIV were significantly less likely to be optimally adherent than adults (adjusted odds ratio [aOR] = .55; 95% confidence interval [CI]: .49-.62), after controlling for potential confounders, although youth adherence improved significantly during the study period. Among youth, increasing time-dependent age (aOR = 1.18/year older; 95%CI: 1.11-1.25) and number of years on antiretroviral therapy (aOR = 1.15, 95%CI: 1.10-1.19) were independently associated with optimal adherence, while Hepatitis C-positive serostatus (aOR = .55; 95%CI: .33-.92) and multiple treatment regimen change (aOR = .89/regimen change; 95%CI: .81-.97) were negatively associated with optimal adherence. Youth were less likely to be optimally adherent throughout the study period. Findings suggest implications for increased youth-centered adherence support, particularly for youth living with HIV concurrently living with Hepatitis C, newly initiating treatment, and going through medication change.
Identifiants
pubmed: 30545583
pii: S1054-139X(18)30445-2
doi: 10.1016/j.jadohealth.2018.10.001
pii:
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
509-515Informations de copyright
Copyright © 2018. Published by Elsevier Inc.