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Comparative Study
. 2008 Aug 1;48(4):408-17.
doi: 10.1097/QAI.0b013e31817bbe80.

Adherence to antiretrovirals among US women during and after pregnancy

Arlene D Bardeguez  1 , Jane C Lindsey, Maureen Shannon, Ruth E Tuomala, Susan E Cohn, Elizabeth Smith, Alice Stek, Shelly Buschur, Amanda Cotter, Linda Bettica, Jennifer S Read; PACTG 1025 Protocol Team
Collaborators, Affiliations
Comparative Study

Adherence to antiretrovirals among US women during and after pregnancy

Arlene D Bardeguez et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Antiretrovirals (ARVs) are recommended for maternal health and to reduce HIV-1 mother-to-child transmission, but suboptimal adherence can counteract its benefits.

Objectives: To describe antepartum and postpartum adherence to ARV regimens and factors associated with adherence.

Methods: We assessed adherence rates among subjects enrolled in Pediatric AIDS Clinical Trials Group Protocol 1,025 from August 2002 to July 2005 on tablet formulations with at least one self-report adherence assessment. Perfectly adherent subjects reported no missed doses 4 days before their study visit. Generalized estimating equations were used to compare antepartum with postpartum adherence rates and to identify factors associated with perfect adherence.

Results: Of 519 eligible subjects, 334/445 (75%) reported perfect adherence during pregnancy. This rate significantly decreased 6, 24, and 48 weeks postpartum [185/284 (65%), 76/118 (64%), and 42/64 (66%), respectively (P < 0.01)]. Pregnant subjects with perfect adherence had lower viral loads. The odds of perfect adherence were significantly higher for women who initiated ARVs during pregnancy (P < 0.01), did not have AIDS (P = 0.02), never missed prenatal vitamins (P < 0.01), never used marijuana (P = 0.05), or felt happy all or most of the time (P < 0.01).

Conclusions: Perfect adherence to ARVs was better antepartum, but overall rates were low. Interventions to improve adherence during pregnancy are needed.

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