Factors sustaining pediatric adherence to antiretroviral therapy in Western Kenya

Rachel C. Vreeman, Winstone M. Nyandiko, Samwel O. Ayaya, Eunice G. Walumbe, David G. Marrero, Thomas S. Inui

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Antiretroviral therapy (ART) requires nearly perfect adherence to be effective. Although 90% of HIV-infected children live in Africa, there are limited data on pediatric adherence from this multicultural continent.We conducted a qualitative study to identify key factors contributing to pediatric ART adherence. Ten focus group discussions (N = 85) and 35 individual interviews were conducted with parents and guardians of HIV-infected children receiving ART in western Kenya. Interviews covered multiple aspects of the experience of having children take ART and factors that inhibited or facilitated medication adherence. Constant comparison, progressive coding, and triangulation methods were used to arrive at a culturally contextualized, conceptual model for pediatric ART adherence derived from the descriptions of the lived experience in this resource-limited setting. Child care, including sustained ART adherence, depends on interacting cultural and environmental determinants at the levels of the individual child, parent/caregiver, household, community, health care system, and society.

Original languageEnglish (US)
Pages (from-to)1716-1729
Number of pages14
JournalQualitative Health Research
Issue number12
StatePublished - Dec 2009
Externally publishedYes


  • Adherence
  • Africa
  • Grounded theory
  • Pediatrics
  • Stigma

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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