Final Facilitator Guide - EngenderHealth

Section 5h. Drug adherence is the most critical factor in treatment success.i. Poor adherence results in drug resistance and treatment failure.4. Differences with adults and issues with ART in children :a. Determining the dose of ART medicine is more complicated.b. Taste issues affect adherence in childrenc. Follow-up is dependent on care takersd. Adherence depends primarily on the caretaker.e. Nevirapine, as a single drug is given during delivery to prevent HIVtransmission to children. However this does not preventtransmission in all children. Among children who become infectedwith HIV in spite of Nevirapine there is likelihood that the virus intheir body will be resistant to Nevirapine. In such cases NevirapinebasedART regimens will not work.f. The family must be counseled and educated about ARV, includingthe need for adherence with follow-up medical visits and withmedications. Giving medication twice daily to a small child withoutever missing a dose is difficult and usually requires the participationof more than one caregiver. One caregiver may be at work or awaywhen a dose is due, and then the other caregiver must give thechild the medication. Usually several counseling sessions shouldbe provided to the family before medications are prescribed, sothat adherence is excellent from the first dose.g. All infants born to HIV positive mothers should be oncotrimoxazole starting at six weeks of age and until theyare proven to NOT have HIV which usually is confirmed at 18months of age. Cotrimoxazole prevents PCP-a kind of pneumonia(an opportunistic infections of the lungs).Facilitator’s Guide4Adherence to Treatment for HIV107