Comprehensive Evaluation of Caregiver-Reported Antiretroviral Therapy Adherence for HIV-Infected Children

Rachel C. Vreeman, Winstone M. Nyandiko, Hai Liu, Wanzhu Tu, Michael L. Scanlon, James E. Slaven, Samuel O. Ayaya, Thomas S. Inui

Research output: Contribution to journalArticle

11 Scopus citations


For HIV-infected children, adherence to antiretroviral therapy (ART) is often assessed by caregiver report but there are few data on their validity. We conducted prospective evaluations with 191 children ages 0–14 years and their caregivers over 6 months in western Kenya to identify questionnaire items that best predicted adherence to ART. Medication Event Monitoring Systems® (MEMS, MWV/AARDEX Ltd., Switzerland) electronic dose monitors were used as external criterion for adherence. We employed a novel variable selection tool using the LASSO technique with logistic regression to identify items best correlated with dichotomized MEMS adherence (≥90 or <90 % doses taken). Nine of 48 adherence items were identified as the best predictors of adherence, including missed or late doses in the past 7 days, problems giving the child medicines, and caregiver-level factors like not being present at medication taking. These items could be included in adherence assessment tools for pediatric patients.

Original languageEnglish (US)
Pages (from-to)626-634
Number of pages9
JournalAIDS and Behavior
Issue number4
StatePublished - Apr 10 2015


  • Adherence
  • Best practice
  • Pediatric HIV care
  • Resource-limited setting

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases
  • Social Psychology

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