The role of cognitive functioning in medication adherence of children and adolescents with HIV infection

Kathleen Malee, Paige L. Williams, Grace Montepiedra, Sharon Nichols, Patricia A. Sirois, Deborah Storm, John Farley, Betsy Kammerer, M. Turcich, L. Harris, I. Iovino, Ann Usitalo, Mobeen H. Rathore, Ayesha Mirza, Saniyyah Mahmoudi, K. Malee, C. Cruz, Nydia Scalley, A. Khadivi, D. MirandaG. B. Scott, C. D. Mitchell, L. Taybo, S. Willumsen, Susan Adubato, Jennis Hanna, P. Sirois, S. Nichols, S. Wilson, R. Shaw, Mitzie L. Grant, Janet S. Chen, Jill A. Foster, Susan McQuiston, J. Homans, M. Neely, L. S. Spencer, A. Kovacs, B. Kammerer, J. Meade, R. Rothermel, L. Schuster, C. Yumoto, M. Miles, T. Cooper, Patricia Garvie, W. Borkowsky, S. Chandwani, N. Deygoo, S. Akleh, S. Bewley, B. Rohwedder, C. Mellins, N. Silverman, Rita Jeremy, R. McEvoy, N. Hutton, B. Griffith, M. Joyner, C. Kiefner, M. Acker, R. Croteau, C. McLellan, K. Mohan, David Breiger, M. Bamji, I. Pathak, S. Manwani, E. Patel, Evelyn Abreu, P. Glass, M. New, D. Marshall, M. Lyon, S. Lee, Margaret Bowden, J. Ackerson, D. Marullo, V. Teppler, V. R. Bonagura, S. J. Schuval, C. Colter, L. Campbell, Kunsang Gyato, Cynthia Chase, Renee Smith, J. Schneider, M. Milazzo, A. Puga, Barbara Kalish, Karen O'Donnell, Felicia Wiley, Kareema Whitfield, Maragaret Donnelly, S. Champion, M. Frere, M. DiGrado, E. J. Abrams, J. Martinez, M. Mancao, Gary Isenberg, J. McKeeman, W. Figueroa, E. Reyes, L. B. Weiner, K. A. Contello, W. A. Holz, M. J. Famiglietti, L. Schiavoni, A. D. Fernandez, P. A. Hughes, N. Wade, M. E. Adams, R. Shaw, J. P. Piatt, J. Foti, L. Clarke-Steffen, J. Sleasman, C. Delaney, M. Cohen, B. Kiernan, W. A. Andiman, S. Romano, L. Hurst, J. De Jesus, Michael Westerveld, G. Wilson, Evon B. Lee, Heather Adams, Geoffrey A. Weinberg, Barbra Murante, Susan Laverty, N. Hutchcon, A. Townley, S. Nesheim, R. Dennis, D. Lindsey-Blue, T. Chenneville, V. Vandewater, G. M. Johnson, H. Gay, S. Sadler, T. Mastandrea, Karen Hickel-Rathburn, D. Johnson, J. Church, T. Dunaway, C. Salata, A. Deveikis, L. Melton, S. Gaur, P. Whitley-Williams, A. Malhotra, L. Cerracchio, M. Dolan, J. D'Agostino, R. Posada, C. Mani, S. Cobb, S. R. Lavoie, T. Y. Smith, A. Feingold, S. Burrows-Clark, J. Mrus, R. Beiting, J. Cass, K. Murdock, Keith Yates, W. Albritton, R. Warford, S. Arpadi, A. Gershon, P. Miller, A. Rubinstein, G. Krienik, M. Nguyen, M. Chau, T. Waxman, C. Forbes, D. Wara, A. Kamrin, S. Farrales, R. Johan-Liang, K. O'Keefe, K. Sirl, M. Cradock, S. Pahwa, L. Rodriquez, S. Cagle, K. Pettit-Kekel, M. Silio

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49 Scopus citations


Objective: To evaluate the relationship between cognitive functioning and medication adherence in children and adolescents with perinatally acquired HIV infection. Methods: Children and adolescents, ages 3-18 (N = 1,429), received a cognitive evaluation and adherence assessment. Multiple logistic regression models were used to identify associations between adherence and cognitive status, adjusting for potential confounding factors. Results: Children's average cognitive performance was within the low-average range; 16% of children were cognitively impaired (MDI/FSIQ <70). Cognitive status was not associated with adherence to full medication regimens; however, children with borderline/low average cognitive functioning (IQ 70-84) had increased odds of nonadherence to the protease inhibitor class of antiretroviral therapy. Recent stressful life events and child health characteristics, such as HIV RNA detectability, were significantly associated with nonadherence. Conclusion: Cognitive status plays a limited role in medication adherence. Child and caregiver psychosocial and health characteristics should inform interventions to support adherence.

Original languageEnglish
Pages (from-to)164-175
Number of pages12
JournalJournal of Pediatric Psychology
Issue number2
StatePublished - Mar 2009
Externally publishedYes


  • Adolescents
  • Children
  • Cognitive functioning
  • HIV
  • Medication adherence


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