Outcomes for optimal adherence were defined as no missed doses of cART in the last three days (100% adherence) and viral load below the limit of detection (< 50 copies/mL) in the

exam closest to enrollment. Data were stored and analyzed using SPSS 18.0 software (SPSS Statistics for Windows, Version 18.0. Chicago, USA). The level of significance adopted in uni- and multivariable logistic regression analyses was 0.05. Contingency tables and respective statistics were used to assess the putative association between predictor variables (e.g., sociodemographic, biological [extracted from patients’ case report Bleomycin in vitro charts], QOL scores, anxiety and depression scores, alcohol and substance use and abuse) and the two outcomes: cART adherence and viral suppression. Multiple logistic regression was used to assess factors that showed association with the outcomes with p-values < 0.25 in the univariate analyses and to investigate independent predictors by controlling for possible confounders. Models fitness was verified by Hosmer-Lemeshow

statistics and analysis of residuals (data not shown). The research protocol was submitted and approved by the institutional review board of each site: Hospital dos Servidores do Estado do Rio de Janeiro (Rio de Janeiro, RJ, Brazil), Fundação de Medicina Tropical do Amazonas (Manaus, AM, Brazil), Instituto de Medicina Integral Prof. AZD5363 supplier Fernando Figueira (Recife, PE, Brazil), Grupo Hospitalar Conceição (Porto Alegre, RS, Brazil), and Universidade Federal de Mato Grosso do Sul (Campo Grande, MS, Brazil). From December of 2009 to April of 2011, 572

HIV-infected children (< 13 years) and adolescents (> Methane monooxygenase 13 and < 18 years) attended HIV clinics at the five participating sites. From this total, 60 were not using cART or had been using it for less than eight weeks; 24 were infected by means other than vertical transmission; 19 did not have a legal guardian; 74 consented but did not complete the study procedures; 48 did not agree to participate; and 87 were not invited due to conflicting schedules. Therefore, 260 pairs of perinatally HIV-infected children or adolescents and their respective caregivers were enrolled into the study and completed the study procedures. Sociodemographic characteristics of enrolled patients were similar to those of the whole group. However, viral suppression among patients on cART was significantly worse among the whole group (51%), when compared to those fully enrolled (58%) (p < 0.01). The study population comprised 203 children (78%) and 57 adolescents (22%). 108/260 (42%) of the patients had HIV testing and diagnosis elicited by a symptomatic/clinical condition (not necessarily an AIDS-defining condition); 76/260 (29%) were tested because someone else in the family had HIV (i.e.