Adherence to antiretroviral treatment among pregnant and postpartum HIV-infected women

Bibliographic Data

ID19439452
AuthorsClaude Ann Mellins (0000-0002-1978-7638, Columbia University, corresponding author), C Chu (b Clinical Trials & Surveys Corp , Baltimore , US), Charmaine Faye M Chu (Clinical Trials and Surveys Corporation), Kathleen Malee (0000-0002-6384-1283, Lurie Children's Hospital), Stuart F H Allison (National Institute of Mental Health), S Allison (d National Institute of Mental Health , Bethesda , US), Reneaki Smith (0009-0003-6191-181X, University of Illinois Chicago), Lynnette Harris (0009-0001-1611-6118, Texas Children's Hospital), A Higgins (Columbia University), C Zorrilla (h University of Puerto Rico School of Medicine , San Juan , Puerto Rico), Sheldon H Landesman (State University of New York), S Landesman (i State University of New York at Brooklyn , New York , US), Leslie Serchuck (National Institute of Child Health), Phillip LaRussa (Columbia University)
Year2008
Volume20
Issue8
Pages958-968
Publication date2008-09-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540120701767208
PMID18608073
OpenAlexW2071661560
LanguageEN
Citations received19
References cited39

Among women with HIV infection, pregnancy is a time when maintenance of maternal health and reduction of vertical HIV transmission are primary concerns. Few studies have examined adherence to Antiretroviral Treatment (ART) during pregnancy and in the postpartum period when the demands of childcare may significantly interfere with women's self-care behaviors. This study examined ART use and adherence in HIV-infected pregnant and postpartum women participating in the Women and Infants Transmission Study (WITS-IV) in the US. Adherence was assessed through a self-report interview during the third trimester of pregnancy and six-month postpartum. Data were also collected on demographics, biomedical markers and health related symptoms. During the third trimester visit, 77% (309/399) of women completed the self-report adherence measure; 61% (188/309) reported complete adherence. Factors associated with non-adherence included advanced HIV disease status, higher HIV-RNA viral load, more health-related symptoms and alcohol and tobacco use. At six-month postpartum, 55% (220/399) completed the measure; 44% (97/220) of these women reported complete adherence. Factors associated with non-adherence during the postpartum period were ethnicity, more health-related symptoms and WITS clinical site. Results of multivariate analyses using Generalized Estimated Equation analyses across the two visits revealed that more health-related symptoms, higher HIV-RNA viral load, increased alcohol use and clinical site were independently associated with ART non-adherence. These analyses indicate that medication adherence is more likely during pregnancy than postpartum in HIV-infected women, perhaps provoked by motivation to reduce vertical transmission and/or intensive antepartum surveillance. Further investigation is warranted to clarify factors implicated in women's decision-making process regarding ART medication adherence

Demographics · Family medicine · Obstetrics · Postpartum period · Pregnancy · Viral load · Young adult · Demography · HIV-related health complications and treatments · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Internal Medicine