Correspondence

Implementation of a comprehensive program including psycho-social and treatment literacy activities to improve adherence to HIV care and treatment for a pediatric population in Kenya

Joelle Van Winghem¹ , Barbara Telfer¹ , Tony Reid² , Judith Ouko¹ , Angela Mutunga¹ , Zaina Jama¹ and Shobha Vakil³

¹Operational Cell Belgium, Médecins Sans Frontières, Nairobi, Kenya

²Operational Research Centre, Médecins Sans Frontières, Brussels, Belgium

³Technical advisor, ART Program, Government of Kenya Ministry of Health, National AIDS and STD Control Programme (NASCOP), Nairobi, Kenya

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BMC Pediatrics 2008, 8:52doi:10.1186/1471-2431-8-52

Published:	21 November 2008

Abstract

Background

To achieve good clinical outcomes with HAART, patient adherence to treatment and care is a key factor. Since the literature on how to care for pediatric HIV patients is limited, we describe here adherence interventions implemented in our comprehensive care program in a resource-limited setting in Kenya.

Methods

We based our program on factors reported to influence adherence to HIV care and treatment. We describe, in detail, our program with respect to how we adapted our clinical settings, implemented psycho-social support activities for children and their caregivers and developed treatment literacy for children and teenagers living with HIV/AIDS.

Results

This paper focused on the details of the program, with the treatment outcomes as secondary. However, our program appeared to have been effective; for 648 children under 15 years of age who were started on HAART, the Kaplan-Meier mortality survival estimate was 95.27% (95%CI 93.16–96.74) at 12 months after the time of initiation of HAART.

Conclusion

Our model of pediatric HIV/AIDS care, focused on a child-centered approach with inclusion of caregivers and extended family, addressed the main factors influencing treatment adherence. It appeared to produce good results and is replicable in resource-limited settings.