A major consideration for starting treatment in children is the child and family’s readiness and motivation to embark on often complex medication regimens. In other words, their ability to start and maintain therapy.

With increasing access and use of antiretroviral therapy to treat HIV infection in children, the importance of supporting adherence cannot be overemphasised.

Essentially, children rely on adult caregivers for their medications and thus the support needs required to aid children in adhering to combination therapies can only be managed by considering the family unit as a whole. Each is dependent on the other and each has an important role to play in maintaining high adherence rates. Children as a group cannot be categorised under a broad umbrella of “paediatrics”. Age-specific differences exist, which require careful consideration when planning and starting antiretroviral therapy. Each cohort has differing support needs and levels of dependence, as does each individual child and family.

Children as a group are known to be a difficult population to administer medications to. The issues surrounding taking antiretroviral therapy to an infant will differ greatly from that of an adolescent. As such strategies to aid adherence need to be age specific and individually focussed. Further information can be obtained from the Children's HIV Association – www.bhiva.org./chiva