Antiretroviral Therapy Adherence and Viral Suppression in HIV‐Infected Drug Users

Comparison of Self‐Report and Electronic Monitoring

Bibliographic Data

ID23333590
AuthorsJulia H Arnsten (0000-0002-7741-1567, Albert Einstein College of Medicine, corresponding author), Penelope Demas (Albert Einstein College of Medicine), Penelope A Demas, Homayoon Farzadegan (Johns Hopkins University), Richard W Grant (0000-0002-6164-8025, Albert Einstein College of Medicine), Marc N Gourevitch (0000-0001-6865-2126, Albert Einstein College of Medicine), Chee‐Jen Chang (0000-0002-7725-7555, Albert Einstein College of Medicine), Donna Buono (0000-0002-3888-0758, Albert Einstein College of Medicine), Haftan Eckholdt (Albert Einstein College of Medicine), Andrea A Howard (0000-0003-3248-1307, Albert Einstein College of Medicine), Ellie E Schoenbaum (0000-0002-0878-284X, Albert Einstein College of Medicine)
Year2001
Volume33
Issue8
Pages1417-1423
Publication date2001-10-15
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueClinical Infectious Diseases (JOURNAL)
Journal identifiersISSN: 1058-4838 • E-ISSN: 1537-6591
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1086/323201
PMID11550118
PMCIDPMC2692641
OpenAlexW2121731508
LanguageEN
Citations received110
References cited24

To compare electronically monitored (MEMS) with self-reported adherence in drug users, including the impact of adherence on HIV load, we conducted a 6-month observational study of 67 antiretroviral-experienced current and former drug users. Adherence (percentage of doses taken as prescribed) was calculated for both the day and the week preceding each of 6 research visits. Mean self-reported 1-day adherence was 79% (median, 86%), and mean self-reported 1-week adherence was 78% (median, 85%). Mean MEMS 1-day adherence was 57% (median, 52%), and mean MEMS 1-week adherence was 53% (median, 49%). One-day and 1-week estimates were highly correlated (r>.8 for both measures). Both self-reported and MEMS adherence were correlated with concurrent HIV load (r=.43-.60), but the likelihood of achieving virologic suppression was greater if MEMS adherence was high than if self-reported adherence was high. We conclude that self-reported adherence is higher than MEMS adherence, but a strong relationship exists between both measures and virus load. However, electronic monitoring is more sensitive than self-report for the detection of nonadherence and should be used in adherence intervention studies.

Antiretroviral medication · Antiretroviral therapy · Drug · Human immunodeficiency virus (HIV) · Observational study · Physical therapy · Viral load · HIV Research and Treatment · HIV/AIDS drug development and treatment · HIV/AIDS Research and Interventions · Immunology · Internal Medicine · Medicine · Pharmacology