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. 2007 Jun 20;2(6):e552.
doi: 10.1371/journal.pone.0000552.

Patient and regimen characteristics associated with self-reported nonadherence to antiretroviral therapy

Patrick S Sullivan  1 , Michael L Campsmith, Glenn V Nakamura, Elin B Begley, Jeffrey Schulden, Allyn K Nakashima
Affiliations

Patient and regimen characteristics associated with self-reported nonadherence to antiretroviral therapy

Patrick S Sullivan et al. PLoS One. .

Abstract

Background: Nonadherence to antiretroviral therapy (ARVT) is an important behavioral determinant of the success of ARVT. Nonadherence may lead to virological failure, and increases the risk of development of drug resistance. Understanding the prevalence of nonadherence and associated factors is important to inform secondary HIV prevention efforts.

Methodology/principal findings: We used data from a cross-sectional interview study of persons with HIV conducted in 18 U.S. states from 2000-2004. We calculated the proportion of nonadherent respondents (took <95% of prescribed doses in the past 48 hours), and the proportion of doses missed. We used multivariate logistic regression to describe factors associated with nonadherence. Nine hundred and fifty-eight (16%) of 5,887 respondents reported nonadherence. Nonadherence was significantly (p<0.05) associated with black race and Hispanic ethnicity; age <40 years; alcohol or crack use in the prior 12 months; being prescribed >or=4 medications; living in a shelter or on the street; and feeling "blue" >or=14 of the past 30 days. We found weaker associations with having both male-male sex and injection drug use risks for HIV acquisition; being prescribed ARVT for >or=21 months; and being prescribed a protease inhibitor (PI)-based regimen not boosted with ritonavir. The median proportion of doses missed was 50%. The most common reasons for missing doses were forgetting and side effects.

Conclusions/significance: Self-reported recent nonadherence was high in our study. Our data support increased emphasis on adherence in clinical settings, and additional research on how providers and patients can overcome barriers to adherence.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Carpenter CC, Fischl MA, Hammer SM, Hirsch MS, Jacobsen DM, et al. Antiretroviral therapy for HIV infection in 1998: updated recommendations of the International AIDS Society-USA Panel. JAMA. 1998;280:78–86. - PubMed
    1. Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133:21–30. - PubMed
    1. Hirsch MS, Conway B, D'Aquila RT, Johnson VA, Brun-Vezinet F, et al. Antiretroviral drug resistance testing in adults with HIV infection: implications for clinical management. International AIDS Society–USA Panel. JAMA. 1998;279:1984–1991. - PubMed
    1. Wood E, Hogg RS, Yip B, Harrigan PR, O'Shaughnessy MV, et al. The impact of adherence on CD4 cell count responses among HIV-infected patients. J Acquir Immune Defic Syndr. 2004;35:261–268. - PubMed
    1. Cohen M. Antiretroviral therapy to prevent sexual transmission of HIV. 13th Conference on Retroviruses and Opportunistic Infections, Denver Colorado, February 2006. Abstract 54.

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