Trying to get a child to take their cough syrup can prove to be a difficult task, but the worst that can happen if they don’t, is a sleepless night – especially considering that non-prescription cough medicine isn’t really effective anyway. But what if the consequences of not taking a medication as prescribed were much more serious?
One of the biggest challenges to properly treating people infected with HIV is getting them to take their medications as prescribed. In Canada, HIV is no longer a death sentence and many adults and teens can become complacent about their treatment. Taking HIV medicines as prescribed is vital to prevent the virus from developing resistance to life-saving medications. When the virus becomes resistant, the drug is no longer effective and if new ones are not available, treatment fails. The issue of adherence to medication is especially challenging when dealing with children.
In general, children dislike the taste of HIV medicines, and subsequently refuse to take them altogether, or vomit after swallowing them. While there are over 16 different anti-HIV medications available to HIV-infected children, the first chewable HIV medication (children’s raltegravir) was recently approved for kids in Canada. Doctors now have a new therapy that we expect children will take more readily for the simple reason that it is palatable and to a child who can not appreciate the importance of their medication, taste matters.
While the prevalence of HIV in children in Canada is low, it is still an in important health concern. Excellent progress has been made to reduce mother-to-child transmission in Canada to levels below two per cent however there are still new cases of infection in children who have emigrated from countries where HIV is endemic.
Beyond prescribing life-saving medications, we must take a multidisciplinary approach to supporting families of these children living with HIV. The biggest challenge for families is accepting that their child is infected. Once they’ve accepted that reality, often we need to work with parents to manage their feelings of guilt, especially if a mother has transmitted the infection to her child. Our job as healthcare professionals for these children is to help support the family as they move through the different stages of life.
We must always aim to educate infected children early on (but at an appropriate age) about living with HIV and how it will affect them throughout their life. Our hope is that by the age of 14 years, the infected adolescents will know and understand their illness. This includes taking ownership of their health by regularly adhering to their therapy and realizing that by doing so they can lead long, normal and productive lives free of serious medical issues as well as looking forward to adulthood and having non-infected children thus breaking the cycle of despair and death that defined HIV/AIDS up until a few years ago.