HealthDay News — For adolescents with perinatally acquired HIV, the prevalence of medication nonadherence and unsuppressed viral load increases with age, according to a study published online July 3 in AIDS.

Deborah Kacanek, ScD, from the Harvard T.H. Chan School of Public Health in Boston, and colleagues conducted a longitudinal study at 15 US clinical sites to examine factors associated with nonadherence and unsuppressed viral load across adolescence among 381 youth with perinatally acquired HIV. Self-reported antiretroviral medication nonadherence and unsuppressed viral load were measured annually.

The researchers found that the prevalence of nonadherence increased from 31 to 50% from preadolescence (8 to 11 years) to late adolescence/young adulthood (19 to 22 years), and unsuppressed viral load prevalence increased from 16 to 40%. Perceived antiretroviral side effects correlated with nonadherence in adjusted analyses in preadolescence/young adulthood, middle adolescence/young adulthood (age 15 to 17 years), and late adolescence/young adulthood. Additional factors associated with nonadherence included use of a buddy system (as an adherence reminder) in preadolescence; identifying as black and use of a buddy system in early adolescence (age 12 to 14 years); and CD4+ less than 15%, unmarried caregiver, indirect exposure to violence, stigma/fear of inadvertent disclose, and stressful life events in middle adolescence.

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“Services to help adolescents with perinatally-acquired HIV navigate typical developmental challenges should recognize age-specific risks and build on sources of resilience at individual, family, social, and structural levels,” the authors write.

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