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

Kathleen Malee; Paige L. Williams; Grace Montepiedra; Sharon Nichols; Patricia A. Sirois; Deborah Storm; John Farley; Betsy Kammerer; M. Turcich; L. Harris; I. Iovino; Ann Usitalo; Mobeen H. Rathore; Ayesha Mirza; Saniyyah Mahmoudi; K. Malee; C. Cruz; Nydia Scalley; A. Khadivi; D. Miranda; G. B. Scott; C. D. Mitchell; L. Taybo; S. Willumsen; Susan Adubato; Jennis Hanna; P. Sirois; S. Nichols; S. Wilson; R. Shaw; Mitzie L. Grant; Janet S. Chen; Jill A. Foster; Susan McQuiston; J. Homans; M. Neely; L. S. Spencer; A. Kovacs; B. Kammerer; J. Meade; R. Rothermel; L. Schuster; C. Yumoto; M. Miles; T. Cooper; Patricia Garvie; W. Borkowsky; S. Chandwani; N. Deygoo; S. Akleh; S. Bewley; B. Rohwedder; C. Mellins; N. Silverman; Rita Jeremy; R. McEvoy; N. Hutton; B. Griffith; M. Joyner; C. Kiefner; M. Acker; R. Croteau; C. McLellan; K. Mohan; David Breiger; M. Bamji; I. Pathak; S. Manwani; E. Patel; Evelyn Abreu; P. Glass; M. New; D. Marshall; M. Lyon; S. Lee; Margaret Bowden; J. Ackerson; D. Marullo; V. Teppler; V. R. Bonagura; S. J. Schuval; C. Colter; L. Campbell; Kunsang Gyato; Cynthia Chase; Renee Smith; J. Schneider; M. Milazzo; A. Puga; Barbara Kalish; Karen O'Donnell; Felicia Wiley; Kareema Whitfield; Maragaret Donnelly; S. Champion; M. Frere; M. DiGrado; E. J. Abrams; J. Martinez; M. Mancao; Gary Isenberg; J. McKeeman; W. Figueroa; E. Reyes; L. B. Weiner; K. A. Contello; W. A. Holz; M. J. Famiglietti; L. Schiavoni; A. D. Fernandez; P. A. Hughes; N. Wade; M. E. Adams; R. Shaw; J. P. Piatt; J. Foti; L. Clarke-Steffen; J. Sleasman; C. Delaney; M. Cohen; B. Kiernan; W. A. Andiman; S. Romano; L. Hurst; J. De Jesus; Michael Westerveld; G. Wilson; Evon B. Lee; Heather Adams; Geoffrey A. Weinberg; Barbra Murante; Susan Laverty; N. Hutchcon; A. Townley; S. Nesheim; R. Dennis; D. Lindsey-Blue; T. Chenneville; V. Vandewater; G. M. Johnson; H. Gay; S. Sadler; T. Mastandrea; Karen Hickel-Rathburn; D. Johnson; J. Church; T. Dunaway; C. Salata; A. Deveikis; L. Melton; S. Gaur; P. Whitley-Williams; A. Malhotra; L. Cerracchio; M. Dolan; J. D'Agostino; R. Posada; C. Mani; S. Cobb; S. R. Lavoie; T. Y. Smith; A. Feingold; S. Burrows-Clark; J. Mrus; R. Beiting; J. Cass; K. Murdock; Keith Yates; W. Albritton; R. Warford; S. Arpadi; A. Gershon; P. Miller; A. Rubinstein; G. Krienik; M. Nguyen; M. Chau; T. Waxman; C. Forbes; D. Wara; A. Kamrin; S. Farrales; R. Johan-Liang; K. O'Keefe; K. Sirl; M. Cradock; S. Pahwa; L. Rodriquez; S. Cagle; K. Pettit-Kekel; M. Silio

doi:10.1093/jpepsy/jsn068

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

Kathleen Malee, Paige L. Williams, Grace Montepiedra, Sharon Nichols, Patricia A. Sirois, Deborah Storm, John Farley, Betsy Kammerer, M. Turcich, L. Harris, I. Iovino, Ann Usitalo, Mobeen H. Rathore, Ayesha Mirza, Saniyyah Mahmoudi, K. Malee, C. Cruz, Nydia Scalley, A. Khadivi, D. MirandaG. B. Scott, C. D. Mitchell, L. Taybo, S. Willumsen, Susan Adubato, Jennis Hanna, P. Sirois, S. Nichols, S. Wilson, R. Shaw, Mitzie L. Grant, Janet S. Chen, Jill A. Foster, Susan McQuiston, J. Homans, M. Neely, L. S. Spencer, A. Kovacs, B. Kammerer, J. Meade, R. Rothermel, L. Schuster, C. Yumoto, M. Miles, T. Cooper, Patricia Garvie, W. Borkowsky, S. Chandwani, N. Deygoo, S. Akleh, S. Bewley, B. Rohwedder, C. Mellins, N. Silverman, Rita Jeremy, R. McEvoy, N. Hutton, B. Griffith, M. Joyner, C. Kiefner, M. Acker, R. Croteau, C. McLellan, K. Mohan, David Breiger, M. Bamji, I. Pathak, S. Manwani, E. Patel, Evelyn Abreu, P. Glass, M. New, D. Marshall, M. Lyon, S. Lee, Margaret Bowden, J. Ackerson, D. Marullo, V. Teppler, V. R. Bonagura, S. J. Schuval, C. Colter, L. Campbell, Kunsang Gyato, Cynthia Chase, Renee Smith, J. Schneider, M. Milazzo, A. Puga, Barbara Kalish, Karen O'Donnell, Felicia Wiley, Kareema Whitfield, Maragaret Donnelly, S. Champion, M. Frere, M. DiGrado, E. J. Abrams, J. Martinez, M. Mancao, Gary Isenberg, J. McKeeman, W. Figueroa, E. Reyes, L. B. Weiner, K. A. Contello, W. A. Holz, M. J. Famiglietti, L. Schiavoni, A. D. Fernandez, P. A. Hughes, N. Wade, M. E. Adams, R. Shaw, J. P. Piatt, J. Foti, L. Clarke-Steffen, J. Sleasman, C. Delaney, M. Cohen, B. Kiernan, W. A. Andiman, S. Romano, L. Hurst, J. De Jesus, Michael Westerveld, G. Wilson, Evon B. Lee, Heather Adams, Geoffrey A. Weinberg, Barbra Murante, Susan Laverty, N. Hutchcon, A. Townley, S. Nesheim, R. Dennis, D. Lindsey-Blue, T. Chenneville, V. Vandewater, G. M. Johnson, H. Gay, S. Sadler, T. Mastandrea, Karen Hickel-Rathburn, D. Johnson, J. Church, T. Dunaway, C. Salata, A. Deveikis, L. Melton, S. Gaur, P. Whitley-Williams, A. Malhotra, L. Cerracchio, M. Dolan, J. D'Agostino, R. Posada, C. Mani, S. Cobb, S. R. Lavoie, T. Y. Smith, A. Feingold, S. Burrows-Clark, J. Mrus, R. Beiting, J. Cass, K. Murdock, Keith Yates, W. Albritton, R. Warford, S. Arpadi, A. Gershon, P. Miller, A. Rubinstein, G. Krienik, M. Nguyen, M. Chau, T. Waxman, C. Forbes, D. Wara, A. Kamrin, S. Farrales, R. Johan-Liang, K. O'Keefe, K. Sirl, M. Cradock, S. Pahwa, L. Rodriquez, S. Cagle, K. Pettit-Kekel, M. Silio

Research output: Contribution to journal › Article › peer-review

49 Scopus citations

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.

Original language	English (US)
Pages (from-to)	164-175
Number of pages	12
Journal	Journal of pediatric psychology
Volume	34
Issue number	2
DOIs	https://doi.org/10.1093/jpepsy/jsn068
State	Published - Mar 2009

Keywords

Adolescents
Children
Cognitive functioning
HIV
Medication adherence

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Developmental and Educational Psychology

Access to Document

10.1093/jpepsy/jsn068

Cite this

Malee, K., Williams, P. L., Montepiedra, G., Nichols, S., Sirois, P. A., Storm, D., Farley, J., Kammerer, B., Turcich, M., Harris, L., Iovino, I., Usitalo, A., Rathore, M. H., Mirza, A., Mahmoudi, S., Malee, K., Cruz, C., Scalley, N., Khadivi, A., ... Silio, M. (2009). The role of cognitive functioning in medication adherence of children and adolescents with HIV infection. Journal of pediatric psychology, 34(2), 164-175. https://doi.org/10.1093/jpepsy/jsn068

Malee, K, Williams, PL, Montepiedra, G, Nichols, S, Sirois, PA, Storm, D, Farley, J, Kammerer, B, Turcich, M, Harris, L, Iovino, I, Usitalo, A, Rathore, MH, Mirza, A, Mahmoudi, S, Malee, K, Cruz, C, Scalley, N, Khadivi, A, Miranda, D, Scott, GB, Mitchell, CD, Taybo, L, Willumsen, S, Adubato, S, Hanna, J, Sirois, P, Nichols, S, Wilson, S, Shaw, R, Grant, ML, Chen, JS, Foster, JA, McQuiston, S, Homans, J, Neely, M, Spencer, LS, Kovacs, A, Kammerer, B, Meade, J, Rothermel, R, Schuster, L, Yumoto, C, Miles, M, Cooper, T, Garvie, P, Borkowsky, W, Chandwani, S, Deygoo, N, Akleh, S, Bewley, S, Rohwedder, B, Mellins, C, Silverman, N, Jeremy, R, McEvoy, R, Hutton, N, Griffith, B, Joyner, M, Kiefner, C, Acker, M, Croteau, R, McLellan, C, Mohan, K, Breiger, D, Bamji, M, Pathak, I, Manwani, S, Patel, E, Abreu, E, Glass, P, New, M, Marshall, D, Lyon, M, Lee, S, Bowden, M, Ackerson, J, Marullo, D, Teppler, V, Bonagura, VR, Schuval, SJ, Colter, C, Campbell, L, Gyato, K, Chase, C, Smith, R, Schneider, J, Milazzo, M, Puga, A, Kalish, B, O'Donnell, K, Wiley, F, Whitfield, K, Donnelly, M, Champion, S, Frere, M, DiGrado, M, Abrams, EJ, Martinez, J, Mancao, M, Isenberg, G, McKeeman, J, Figueroa, W, Reyes, E, Weiner, LB, Contello, KA, Holz, WA, Famiglietti, MJ, Schiavoni, L, Fernandez, AD, Hughes, PA, Wade, N, Adams, ME, Shaw, R, Piatt, JP, Foti, J, Clarke-Steffen, L, Sleasman, J, Delaney, C, Cohen, M, Kiernan, B, Andiman, WA, Romano, S, Hurst, L, De Jesus, J, Westerveld, M, Wilson, G, Lee, EB, Adams, H, Weinberg, GA, Murante, B, Laverty, S, Hutchcon, N, Townley, A, Nesheim, S, Dennis, R, Lindsey-Blue, D, Chenneville, T, Vandewater, V, Johnson, GM, Gay, H, Sadler, S, Mastandrea, T, Hickel-Rathburn, K, Johnson, D, Church, J, Dunaway, T, Salata, C, Deveikis, A, Melton, L, Gaur, S, Whitley-Williams, P, Malhotra, A, Cerracchio, L, Dolan, M, D'Agostino, J, Posada, R, Mani, C, Cobb, S, Lavoie, SR, Smith, TY, Feingold, A, Burrows-Clark, S, Mrus, J, Beiting, R, Cass, J, Murdock, K, Yates, K, Albritton, W, Warford, R, Arpadi, S, Gershon, A, Miller, P, Rubinstein, A, Krienik, G, Nguyen, M, Chau, M, Waxman, T, Forbes, C, Wara, D, Kamrin, A, Farrales, S, Johan-Liang, R, O'Keefe, K, Sirl, K, Cradock, M, Pahwa, S, Rodriquez, L, Cagle, S, Pettit-Kekel, K & Silio, M 2009, 'The role of cognitive functioning in medication adherence of children and adolescents with HIV infection', Journal of pediatric psychology, vol. 34, no. 2, pp. 164-175. https://doi.org/10.1093/jpepsy/jsn068

@article{5914dd971d0347a3a979f1ce8e7b11d0,

title = "The role of cognitive functioning in medication adherence of children and adolescents with HIV infection",

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.",

keywords = "Adolescents, Children, Cognitive functioning, HIV, Medication adherence",

author = "Kathleen Malee and Williams, {Paige L.} and Grace Montepiedra and Sharon Nichols and Sirois, {Patricia A.} and Deborah Storm and John Farley and Betsy Kammerer and M. Turcich and L. Harris and I. Iovino and Ann Usitalo and Rathore, {Mobeen H.} and Ayesha Mirza and Saniyyah Mahmoudi and K. Malee and C. Cruz and Nydia Scalley and A. Khadivi and D. Miranda and Scott, {G. B.} and Mitchell, {C. D.} and L. Taybo and S. Willumsen and Susan Adubato and Jennis Hanna and P. Sirois and S. Nichols and S. Wilson and R. Shaw and Grant, {Mitzie L.} and Chen, {Janet S.} and Foster, {Jill A.} and Susan McQuiston and J. Homans and M. Neely and Spencer, {L. S.} and A. Kovacs and B. Kammerer and J. Meade and R. Rothermel and L. Schuster and C. Yumoto and M. Miles and T. Cooper and Patricia Garvie and W. Borkowsky and S. Chandwani and N. Deygoo and S. Akleh and S. Bewley and B. Rohwedder and C. Mellins and N. Silverman and Rita Jeremy and R. McEvoy and N. Hutton and B. Griffith and M. Joyner and C. Kiefner and M. Acker and R. Croteau and C. McLellan and K. Mohan and David Breiger and M. Bamji and I. Pathak and S. Manwani and E. Patel and Evelyn Abreu and P. Glass and M. New and D. Marshall and M. Lyon and S. Lee and Margaret Bowden and J. Ackerson and D. Marullo and V. Teppler and Bonagura, {V. R.} and Schuval, {S. J.} and C. Colter and L. Campbell and Kunsang Gyato and Cynthia Chase and Renee Smith and J. Schneider and M. Milazzo and A. Puga and Barbara Kalish and Karen O'Donnell and Felicia Wiley and Kareema Whitfield and Maragaret Donnelly and S. Champion and M. Frere and M. DiGrado and Abrams, {E. J.} and J. Martinez and M. Mancao and Gary Isenberg and J. McKeeman and W. Figueroa and E. Reyes and Weiner, {L. B.} and Contello, {K. A.} and Holz, {W. A.} and Famiglietti, {M. J.} and L. Schiavoni and Fernandez, {A. D.} and Hughes, {P. A.} and N. Wade and Adams, {M. E.} and R. Shaw and Piatt, {J. P.} and J. Foti and L. Clarke-Steffen and J. Sleasman and C. Delaney and M. Cohen and B. Kiernan and Andiman, {W. A.} and S. Romano and L. Hurst and {De Jesus}, J. and Michael Westerveld and G. Wilson and Lee, {Evon B.} and Heather Adams and Weinberg, {Geoffrey A.} and Barbra Murante and Susan Laverty and N. Hutchcon and A. Townley and S. Nesheim and R. Dennis and D. Lindsey-Blue and T. Chenneville and V. Vandewater and Johnson, {G. M.} and H. Gay and S. Sadler and T. Mastandrea and Karen Hickel-Rathburn and D. Johnson and J. Church and T. Dunaway and C. Salata and A. Deveikis and L. Melton and S. Gaur and P. Whitley-Williams and A. Malhotra and L. Cerracchio and M. Dolan and J. D'Agostino and R. Posada and C. Mani and S. Cobb and Lavoie, {S. R.} and Smith, {T. Y.} and A. Feingold and S. Burrows-Clark and J. Mrus and R. Beiting and J. Cass and K. Murdock and Keith Yates and W. Albritton and R. Warford and S. Arpadi and A. Gershon and P. Miller and A. Rubinstein and G. Krienik and M. Nguyen and M. Chau and T. Waxman and C. Forbes and D. Wara and A. Kamrin and S. Farrales and R. Johan-Liang and K. O'Keefe and K. Sirl and M. Cradock and S. Pahwa and L. Rodriquez and S. Cagle and K. Pettit-Kekel and M. Silio",

note = "Funding Information: We thank the children and their families, the Study Team and the individuals and institutions involved in the conduct of PACTG 219C for contributing to this research. This study was funded by the United States National Institute of Allergy and Infectious Diseases. This work was supported by the Statistical and Data Analysis Center (SDAC) of the Pediatric AIDS Clinical Trials group at the Harvard School of Public Health under the National Institute of Allergy and Infectious Diseases cooperative agreement No. 5U01 A141110. The following institutions were involved in the design, data collection, and conduct of PACTG 219C, but were not involved in the present analysis, the interpretation of the data, the writing of the article, or the decision to submit for publication.",

year = "2009",

month = mar,

doi = "10.1093/jpepsy/jsn068",

language = "English (US)",

volume = "34",

pages = "164--175",

journal = "Journal of pediatric psychology",

issn = "0146-8693",

publisher = "Oxford University Press",

number = "2",

}

TY - JOUR

T1 - The role of cognitive functioning in medication adherence of children and adolescents with HIV infection

AU - Malee, Kathleen

AU - Williams, Paige L.

AU - Montepiedra, Grace

AU - Nichols, Sharon

AU - Sirois, Patricia A.

AU - Storm, Deborah

AU - Farley, John

AU - Kammerer, Betsy

AU - Turcich, M.

AU - Harris, L.

AU - Iovino, I.

AU - Usitalo, Ann

AU - Rathore, Mobeen H.

AU - Mirza, Ayesha

AU - Mahmoudi, Saniyyah

AU - Malee, K.

AU - Cruz, C.

AU - Scalley, Nydia

AU - Khadivi, A.

AU - Miranda, D.

AU - Scott, G. B.

AU - Mitchell, C. D.

AU - Taybo, L.

AU - Willumsen, S.

AU - Adubato, Susan

AU - Hanna, Jennis

AU - Sirois, P.

AU - Nichols, S.

AU - Wilson, S.

AU - Shaw, R.

AU - Grant, Mitzie L.

AU - Chen, Janet S.

AU - Foster, Jill A.

AU - McQuiston, Susan

AU - Homans, J.

AU - Neely, M.

AU - Spencer, L. S.

AU - Kovacs, A.

AU - Kammerer, B.

AU - Meade, J.

AU - Rothermel, R.

AU - Schuster, L.

AU - Yumoto, C.

AU - Miles, M.

AU - Cooper, T.

AU - Garvie, Patricia

AU - Borkowsky, W.

AU - Chandwani, S.

AU - Deygoo, N.

AU - Akleh, S.

AU - Bewley, S.

AU - Rohwedder, B.

AU - Mellins, C.

AU - Silverman, N.

AU - Jeremy, Rita

AU - McEvoy, R.

AU - Hutton, N.

AU - Griffith, B.

AU - Joyner, M.

AU - Kiefner, C.

AU - Acker, M.

AU - Croteau, R.

AU - McLellan, C.

AU - Mohan, K.

AU - Breiger, David

AU - Bamji, M.

AU - Pathak, I.

AU - Manwani, S.

AU - Patel, E.

AU - Abreu, Evelyn

AU - Glass, P.

AU - New, M.

AU - Marshall, D.

AU - Lyon, M.

AU - Lee, S.

AU - Bowden, Margaret

AU - Ackerson, J.

AU - Marullo, D.

AU - Teppler, V.

AU - Bonagura, V. R.

AU - Schuval, S. J.

AU - Colter, C.

AU - Campbell, L.

AU - Gyato, Kunsang

AU - Chase, Cynthia

AU - Smith, Renee

AU - Schneider, J.

AU - Milazzo, M.

AU - Puga, A.

AU - Kalish, Barbara

AU - O'Donnell, Karen

AU - Wiley, Felicia

AU - Whitfield, Kareema

AU - Donnelly, Maragaret

AU - Champion, S.

AU - Frere, M.

AU - DiGrado, M.

AU - Abrams, E. J.

AU - Martinez, J.

AU - Mancao, M.

AU - Isenberg, Gary

AU - McKeeman, J.

AU - Figueroa, W.

AU - Reyes, E.

AU - Weiner, L. B.

AU - Contello, K. A.

AU - Holz, W. A.

AU - Famiglietti, M. J.

AU - Schiavoni, L.

AU - Fernandez, A. D.

AU - Hughes, P. A.

AU - Wade, N.

AU - Adams, M. E.

AU - Shaw, R.

AU - Piatt, J. P.

AU - Foti, J.

AU - Clarke-Steffen, L.

AU - Sleasman, J.

AU - Delaney, C.

AU - Cohen, M.

AU - Kiernan, B.

AU - Andiman, W. A.

AU - Romano, S.

AU - Hurst, L.

AU - De Jesus, J.

AU - Westerveld, Michael

AU - Wilson, G.

AU - Lee, Evon B.

AU - Adams, Heather

AU - Weinberg, Geoffrey A.

AU - Murante, Barbra

AU - Laverty, Susan

AU - Hutchcon, N.

AU - Townley, A.

AU - Nesheim, S.

AU - Dennis, R.

AU - Lindsey-Blue, D.

AU - Chenneville, T.

AU - Vandewater, V.

AU - Johnson, G. M.

AU - Gay, H.

AU - Sadler, S.

AU - Mastandrea, T.

AU - Hickel-Rathburn, Karen

AU - Johnson, D.

AU - Church, J.

AU - Dunaway, T.

AU - Salata, C.

AU - Deveikis, A.

AU - Melton, L.

AU - Gaur, S.

AU - Whitley-Williams, P.

AU - Malhotra, A.

AU - Cerracchio, L.

AU - Dolan, M.

AU - D'Agostino, J.

AU - Posada, R.

AU - Mani, C.

AU - Cobb, S.

AU - Lavoie, S. R.

AU - Smith, T. Y.

AU - Feingold, A.

AU - Burrows-Clark, S.

AU - Mrus, J.

AU - Beiting, R.

AU - Cass, J.

AU - Murdock, K.

AU - Yates, Keith

AU - Albritton, W.

AU - Warford, R.

AU - Arpadi, S.

AU - Gershon, A.

AU - Miller, P.

AU - Rubinstein, A.

AU - Krienik, G.

AU - Nguyen, M.

AU - Chau, M.

AU - Waxman, T.

AU - Forbes, C.

AU - Wara, D.

AU - Kamrin, A.

AU - Farrales, S.

AU - Johan-Liang, R.

AU - O'Keefe, K.

AU - Sirl, K.

AU - Cradock, M.

AU - Pahwa, S.

AU - Rodriquez, L.

AU - Cagle, S.

AU - Pettit-Kekel, K.

AU - Silio, M.

N1 - Funding Information: We thank the children and their families, the Study Team and the individuals and institutions involved in the conduct of PACTG 219C for contributing to this research. This study was funded by the United States National Institute of Allergy and Infectious Diseases. This work was supported by the Statistical and Data Analysis Center (SDAC) of the Pediatric AIDS Clinical Trials group at the Harvard School of Public Health under the National Institute of Allergy and Infectious Diseases cooperative agreement No. 5U01 A141110. The following institutions were involved in the design, data collection, and conduct of PACTG 219C, but were not involved in the present analysis, the interpretation of the data, the writing of the article, or the decision to submit for publication.

PY - 2009/3

Y1 - 2009/3

N2 - 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.

AB - 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.

KW - Adolescents

KW - Children

KW - Cognitive functioning

KW - HIV

KW - Medication adherence

UR - http://www.scopus.com/inward/record.url?scp=60749113748&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=60749113748&partnerID=8YFLogxK

U2 - 10.1093/jpepsy/jsn068

DO - 10.1093/jpepsy/jsn068

M3 - Article

C2 - 18647794

AN - SCOPUS:60749113748

SN - 0146-8693

VL - 34

SP - 164

EP - 175

JO - Journal of pediatric psychology

JF - Journal of pediatric psychology

IS - 2

ER -

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

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