Medical Research: What is the background for this study? What are the main findings?
Dr. Lowenthal: Between 2005 and 2012, HIV related deaths declined by 30% worldwide. However, during the same time period, HIV related deaths increased 50% among adolescents. Over 90% of HIV-infected children and adolescents live in sub-Saharan Africa and HIV is the leading cause of death among adolescents in Africa. Treatment is available that can allow babies born with HIV to live to be healthy adults. However, strict adherence to these medicines is necessary and often becomes a great challenge during adolescence. In our study of 300 adolescents (ages 10-19) in Botswana, my team found that adolescents who come to clinic without a parent or guardian have a 4.5X greater odds of failing their HIV treatment.
Medical Research: What should clinicians and patients take away from your report?
Dr. Lowenthal: Frequently, during early adolescence, patients with chronic diseases are relatively good about taking their medications. Parents often give these adolescents more autonomy over their own healthcare before they are truly ready to sustain excellent adherence to their medicines long-term. Patients need to ask for help when they need it and clinicians and parents need to provide as much support as they can in a nonjudgmental manner, especially during the challenging late adolescent years. The lives of these young people depend on this support.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Lowenthal: Developing strategies to improve communication between adolescents and their parents and adolescents and their healthcare providers is important for the support of adolescents with HIV and other chronic diseases. In resource-limited settings, where the vast majority of HIV-infected adolescents live, we need to investigate strategies that can be sustainable with limited financial support.
MedicalResearch.com Interview with:Elizabeth Lowenthal, MD MSCE (2015). Adolescents Risk Failing HIV Treatment If No Parent Attends Clinic Visits