By Douglas Mazanec

Reuters 15 March 2001

New York -- Less than half of adolescents with HIV are taking their medications as required, increasing the risk both to themselves and the community, researchers report.

A study of 161 teens infected with HIV found that only 41% were taking all their medications as required. The report is published in the February issue of AIDS Care.

"Strict adherence to drug therapy is critical for keeping the virus suppressed,'' according to one of the study's co-authors, Dr. Craig Wilson, an associate professor of pediatrics at the University of Alabama at Birmingham.

"Partial compliance not only allows the virus to multiply, but it encourages the growth of strains that may be resistant to currently available drugs,'' he told Reuters Health. "If others become infected with these new strains, it could create a public health problem.''

One of main reasons for such noncompliance appears to be depression. Of those teens in the study that were depressed, only 29% took their medications as required.

Authors of the study suggest that healthcare workers may need to screen for and treat adolescent depression before they can expect better compliance. Yet depression is not the only suggestive factor since even among nondepressed teens, only 55% showed full compliance. The other factor that contributes to poor adherence is the quantity of pills that those with HIV need to take each day.

"It's not unusual for a patient to have to take three or four different drugs, three times a day,'' he told Reuters Health. "If such a regimen is hard for adults to follow, you can imagine the challenge it poses for less disciplined teenagers.''

This second hurdle to compliance will become lower in the near future, the researchers suggest, as pharmaceutical companies develop medications that last longer and combine two drugs in one pill.