Adherence to ARV Treatment in Adolescents Flashcards
What is the main cause of treatment failure in HIV, particularly among adolescents?
Poor adherence to antiretroviral therapy (ART) is the main cause of treatment failure, and this is especially problematic among adolescents.
How much of the time must ART be taken to ensure viral suppression?
ART must be taken more than 95% of the time to ensure viral suppression, with no more than 2 to 3 doses per month being missed.
How should adherence to ART be managed?
Adherence to ART should be agreed upon through a shared decision-making process between healthcare providers and patients.
What is the attitude of sexually active HIV-positive adolescents towards protecting their partners?
Anecdotal research suggests that sexually active HIV-positive adolescents all wish to protect their partners.
How long does it typically take for viral load to drop to undetectable levels when on ART, and what does this mean for transmission?
Viral load typically drops to undetectable levels within 6 months when on ART, and undetectable viral load means untransmissible HIV.
How is virological failure defined according to the World Health Organization (WHO)?
Virological failure is defined by WHO as having two consecutive viral loads of greater than 1,000 copies, measured 3 to 6 months apart with interval adherence support.
How frequently is viral load measured in South Africa after initiating antiretroviral therapy (ART)?
In South Africa, viral load is measured at 6 and 12 months after ART initiation, and annually thereafter.
What additional adherence support is provided to young patients between their first and second viral load tests in South Africa?
Enhanced adherence counseling is given to young patients between their first and second viral load tests, preferably on the same day as receiving the viral load results.
What is immunological failure in the context of HIV treatment?
Immunological failure is indicated by a low CD4 count, suggesting inadequate response to antiretroviral therapy.
What is clinical failure in the context of HIV treatment?
Clinical failure refers to the development of opportunistic infections and other illnesses, which may be indicated by a combination of virological failure, immunological failure, and clinical symptoms.
Problems with adherence arise when regimen is changed due to _____ ______ (2nd or 3rd line regimens even tougher to adhere to)
10-14 y/os have a higher ____ _______ rate than 15-19y/os, but adolescents as a whole have lower rates than adults and younger children
drug resistance
viral suppression
Adherence challenges at an individual level:
Adherence challenges relating to medication:
Adherence challenges at a social level:
Adherence challenges relating to health services:
Solutions:
