Abstract:
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 to 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.
