Reflections on Person-Centered Care as Key in HIV Treatment Adherence

“Over and over, we see stagnating viral load suppression among children,” says Baker Sserwambala, the orphans and vulnerable children strategic information and program director of the USAID Integrated Children and Youth Development Activity in Uganda. HIV viral load suppression rate among Ugandan children remains lower than that of adults; there, as in many countries, the HIV response is lagging behind the global targets for children.

Staff from The Bantwana Initiative of World Education attended the 2023 Adherence Conference, hosted on June 11-13 by the International Association of Providers of AIDS Care and the Albert Einstein College of Medicine-Montefiore Medical Center in Puerto Rico. This conference convened researchers, community organizers, medical practitioners, and program implementers from around the world to discuss interventions and research on HIV prevention and treatment adherence across demographics and geographies.

“We cannot just apply the same programming we have developed for adults to children. They have unique and silent clinical and socio-economic barriers that make consistent adherence to treatment challenging. At home they may have insufficient food to take the medications, pill burden or bitter taste, or unreliable or forgetful caregivers who cannot facilitate adherence. At school, they might miss doses for fear of discrimination, or have uninvolved teachers. At the clinic, they may interrupt treatment or have an unoptimized regimen. Effective adherence ultimately requires a holistic, age-sensitive assessment and response to treatment barriers, directly observed treatment for non-suppressed children and family-driven solutions,” says Baker.

During his presentation, Baker said that root cause analysis and joint action planning to strengthen clinical and community services improved viral suppression rates among children and adolescents living with HIV between October 2021 and June 2022, resulting in more than 900 children and adolescents achieving viral suppression.

Read more on our takeaways from the Adherence Conference, including from our colleagues at JSI and The Center for HIV and Infectious Diseases at JSI and World Education.