The role of cognitive functioning in medication adherence of children and adolescents with HIV infection

J Pediatr Psychol. 2009 Mar;34(2):164-75. doi: 10.1093/jpepsy/jsn068. Epub 2008 Jul 22.

Abstract

Objective: To evaluate the relationship between cognitive functioning and medication adherence in children and adolescents with perinatally acquired HIV infection.

Methods: Children and adolescents, ages 3-18 (N = 1,429), received a cognitive evaluation and adherence assessment. Multiple logistic regression models were used to identify associations between adherence and cognitive status, adjusting for potential confounding factors.

Results: Children's average cognitive performance was within the low-average range; 16% of children were cognitively impaired (MDI/FSIQ <70). Cognitive status was not associated with adherence to full medication regimens; however, children with borderline/low average cognitive functioning (IQ 70-84) had increased odds of nonadherence to the protease inhibitor class of antiretroviral therapy. Recent stressful life events and child health characteristics, such as HIV RNA detectability, were significantly associated with nonadherence.

Conclusion: Cognitive status plays a limited role in medication adherence. Child and caregiver psychosocial and health characteristics should inform interventions to support adherence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Retroviral Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / epidemiology*
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology*
  • Humans
  • Intelligence Tests
  • Male
  • Neuropsychological Tests
  • Patient Compliance / statistics & numerical data*
  • Prospective Studies
  • Severity of Illness Index

Substances

  • Anti-Retroviral Agents