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. 2023 Jan;35(1):53-62.
doi: 10.1080/09540121.2022.2125159. Epub 2022 Sep 28.

Caregivers' psychosocial assessment for identifying HIV-infected infants at risk of poor treatment adherence: an exploratory study in southern Mozambique

Maria Grazia Lain  1 , Sergio Chicumbe  2 , Anna Cantarutti  3   4 , Gloria Porcu  3   4 , Loide Cardoso  1 , Nicola Cotugno  5   6 , Paolo Palma  5   6 , Rajendra Pahwa  7 , Suresh Pallikkuth  7 , Stefano Rinaldi  7 , Paula Vaz  1 , Savita Pahwa  7
Affiliations

Caregivers' psychosocial assessment for identifying HIV-infected infants at risk of poor treatment adherence: an exploratory study in southern Mozambique

Maria Grazia Lain et al. AIDS Care. 2023 Jan.

Abstract

Psychosocial support (PSS) to caregivers of HIV-infected infants on antiretroviral treatment (ART) is crucial to ensure ART adherence and sustained long-term viral suppression in children. A specific approach including tools to monitor and understand adherence behavior and risk factors that prevent optimal treatment compliance are urgently needed. This qualitative exploratory study, conducted in southern Mozambique, monitored the infants' viral response trajectories during 18 months follow-up, as a measure of adherence, reviewed the caregiver's PSS session notes and the answers to a study questionnaire, to analyze whether the standard PSS checklist applied to infants' caregivers can identify barriers influencing their adherence. Only 9 of 31 infants had sustained virologic response. Reported factors affecting adherence were: difficulties in drugs administration, shared responsibility to administer treatment; disclosure of child's HIV status to family members but lack of engagement; mother's ART interruption and poor viral response. In conclusion, we found that the standard PSS approach alone, applied to caregivers, was lacking focus on many relevant matters that were identified by the study questionnaire. A comprehensive patient-centered PSS package of care, including an adherence risk factor monitoring tool, tailored to caregivers and their children must be developed.

Keywords: Antiretroviral therapy; HIV-infected infants; Mozambique; adherence; psychosocial support; viral suppression.

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Conflict of interest statement

Disclosure statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Individual trajectories of viral load of infants who reached viral suppression during follow-up.
Figure 2.
Figure 2.
Individual trajectories of viral load of infants who never reached viral suppression during follow-up.
See this image and copyright information in PMC

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