Journal Article

Antiretroviral Therapy Adherence and Viral Suppression in HIV-Infected Drug Users: Comparison of Self-Report and Electronic Monitoring

Julia H. Arnsten, Penelope A. Demas, Homayoon Farzadegan, Richard W. Grant, Marc N. Gourevitch, Chee-Jen Chang, Donna Buono, Haftan Eckholdt, Andrea A. Howard and Ellie E. Schoenbaum

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 8, pages 1417-1423
Published in print October 2001 | ISSN: 1058-4838
Published online October 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/323201
Antiretroviral Therapy Adherence and Viral Suppression in HIV-Infected Drug Users: Comparison of Self-Report and Electronic Monitoring

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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.

Journal Article.  4196 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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