Recorded presentation

Nancy L VanDevanter, DrPH, Mary K. Irvine, MPH, Saba A Jearld, MPH, Danielle Greene, MPH, Cheryl Merzel, DrPH, and Emily A. Nishi, MPA. Center for Applied Public Health, Mailman School of Public Health, Columbia University, 722 W. 168 St, New York, NY 10032, 212 305 1166, nlv1@columbia.edu

Background: Adherence to HAART presents significant challenges for caregivers of children perinatally infected with HIV. This study explores from the caregivers’ perspectives what aspects of HIV services contribute to HAART adherence. Methods: Qualitative interviews were conducted with a purposive sample of 30 caregivers recruited from Ryan White CARE Act Title IV clinics. Respondents included biological, kinship and non-kinship-adoptive caregivers between the ages of 29 and 73; 90% were female, 60% African-American, and 40% Latino. Interviews explored coordinative, informational, environmental, and interpersonal aspects of care. All sessions were audio-taped, transcribed, coded independently by two researchers, and analyzed in ATLAS.ti. Results: Caregivers described three aspects of their care contributing to HAART adherence: 1) Service Logistics. Flexibility of appointment scheduling is critical, as most caregivers have multiple demands on their time. Caregivers felt that clinic staff members understood this, and worked with them on scheduling, transportation and childcare to ensure that they could make up missed appointments. 2) Coordination of Services. Caregivers found “one-stop shopping” and the integration of adherence services into medical appointments for their children most helpful. Their providers frequently organized pharmacy home delivery services. 3) Adherence-specific Strategies. Caregivers cited clinicians teaching them specific strategies to reduce barriers to pediatric adherence, such as dissolving large pills in liquid, masking the taste of medications, and developing reward systems, games or other methods to decrease their children’s resistance to taking medications. Conclusion: Caregivers found services that were flexible, coordinated, and adherence-specific to be most helpful in maintaining HAART adherence for their children.

Learning Objectives:

• To identify three different aspects of coordinated care as described by caregivers of children living with HIV
• To describe the impact of coordinated care on adherence to HIV medications

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation