Carol E. Golin|Honghu Liu|Ron D. Hays|Loren G. Miller|Christopher Beck|Jeanette Ickovics|Andrew H. Kaplan|Neil S. Wenger
A prospective study of predictors of adherence to combination antiretroviral medication
University of North Carolina at Chapel Hill|University of California, Los Angeles|University of California, Los Angeles|UCLA Medical Center|Harbor–UCLA Medical Center|UCLA Medical Center|Harbor–UCLA Medical Center|Yale University|University of North Carolina at Chapel Hill|Black AIDS Institute
adherence complex antiretroviral therapy art critical hiv treatment difficult achieve development interventions improve adherence requires detailed information regarding barriers adherence however short followup inadequate adherence measures hampered determinations sought assess predictors longterm 1 year adherence newly initiated combination art using accurate objective adherence measurea prospective cohort study 140 hivinfected patients county hospital hiv clinic year following initiation new highly active art regimenwe measured adherence every 4 weeks computing composite score electronic medication bottle caps pill count selfreport evaluated patient demographic biomedical psychosocial characteristics features regimen relationship ones hiv provider predictors adherence 48 weeks average subjects took 71 prescribed doses 95 patients achieving suboptimal 95 adherence multivariate analyses africanamerican ethnicity lower income education alcohol use higher dose frequency fewer adherence aids eg pillboxes timers independently associated worse adherence adjusting demographic clinical factors actively using drugs took 59 doses versus 72 nonusers drinking alcohol took 66 doses versus 74 nondrinkers patients antiretroviral doses per day adhered less well participants using adherence aids took 68 doses versus 76 upper quartile number adherence aids usednearly patients adherence levels suboptimal demonstrating critical need programs assist patients medication taking interventions assess treat substance abuse incorporate adherence aids may particularly helpful warrant study