Published online April 1, 2008
PEDIATRICS Vol. 121 No. 4 April 2008, pp. e787-e793 (doi:10.1542/peds.2007-1586)
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ARTICLE

Association Between Living With Children and Adherence to Highly Active Antiretroviral Therapy in the Women's Interagency HIV Study

Daniel J. Merenstein, MDa, Michael F. Schneider, MSb, Christopher Cox, PhDb, Rebecca Schwartz, PhDc, Kathleen Weber, BSNd, Esther Robison, PhDe, Monica Gandhi, MD, MPHf, Jean Richardson, DrPHg and Michael W. Plankey, PhDh

a Department of Family Medicine, Georgetown University Medical Center, Washington, District of Columbia
b Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
c State University of New York Downstate Medical Center, Brooklyn, New York
d John H. Stroger Hospital of Cook County, Chicago, Illinois
e Montefiore Medical Center, Bronx, New York
f Department of Medicine, University of California, San Francisco, San Francisco, California
g Keck School of Medicine, University of Southern California, Los Angeles, California
h Department of Medicine, Georgetown University Medical Center, Washington, District of Columbia

OBJECTIVE. The purpose of this work was to evaluate whether living with children adversely affects adherence to highly active antiretroviral therapy in HIV-infected women.

PARTICIPANTS AND METHODS. We conducted a prospective cohort study between October 1998 and September 2005. The study outcome was ≥95% adherence to highly active antiretroviral therapy evaluated at 5832 semiannual visits among 1366 HIV-infected women in the Women's Interagency HIV Study. The primary exposure defined at the visit immediately before outcome ascertainment was the number of children ≤18 years of age reported living in the household.

RESULTS. The percentage of women who reported ≥2 children in the household who also reported ≥95% adherence ranged from 68% to 75% compared with adherence when either 1 child or no children were reported. Each additional child reported living in the household was associated with a 6% decrease in the odds of ≥95% adherence.

CONCLUSION. The impact of living with a child on the ability to take medications by HIV-infected women has not been examined thoroughly. Our data suggest that adherence to highly active antiretroviral therapy is inversely associated with the number of children living in the household.

Key Words: adherence • children • HAART • HIV

Abbreviations: HAART—highly active antiretroviral therapy • WIHS—Women's Interagency HIV Study • ARV—antiretroviral therapy • NRTI—nucleoside reverse transcriptase inhibitor • PI—protease inhibitor • NNRTI—nonnucleoside reverse transcriptase inhibitor • CESD—Center for Epidemiologic Studies Depression Scale • OR—odds ratio • CI—confidence interval

Accepted Aug 29, 2007.