Coordinated, comprehensive, family-centered systems of care often can address many of the daily problems facing families that may affect adherence to complex medical regimens. Case managers, mental health counselors, peer educators, outreach workers, and other members of the multidisciplinary team often may be able to address specific barriers to adherence. HIV-infected adolescents have specific adherence problems. Comprehensive systems of care are required to serve both the medical and psychosocial needs of HIV-infected adolescents, who are frequently inexperienced with healthcare systems. Treatment regimens for adolescents must balance the goal of prescribing a maximally potent antiretroviral regimen with realistic assessment of existing and potential support systems to facilitate adherence.
Developmental issues make caring for adolescents unique.
The adolescent's approach to illness is often different from that of adults. The concrete thought processes of adolescents make it difficult for them to take medications when they are asymptomatic, particularly if the medications have side effects. Adherence with complex regimens is particularly challenging at a time of life when adolescents do not want to be different from their peers. Further difficulties face adolescents who live with parents to whom they have not yet disclosed their HIV status and those who are homeless and have no place to store medicine.