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Factors associated with adherence amongst 5,295 people on antiretroviral therapy as part of an international trial

Factors associated with adherence amongst 5,295 people on antiretroviral therapy as part of an international trial

We assessed factors associated with antiretroviral therapy (ART) adherence including specific ART medications. The Strategies for Management of Antiretroviral Therapy study was an international ART treatment strategy trial that compared CD4+ T-cell-driven intermittent therapy to continuous ART. Adherence was measured using 7-day self-report. We defined high adherence as self-report of taking ‘all’ pills for each prescribed ART medication, all others had suboptimal adherence. Factors associated with adherence were assessed using logistic regression with generalized estimating equations. Participants reported suboptimal adherence in 6,016 (17%) of 35,695 study visits. Factors independently associated with suboptimal adherence were black race, protease inhibitor containing regimens, higher maximum number of doses per day and smoking. Factors independently associated with higher adherence were older age, higher education, region of residence, episodic treatment, higher latest (at time of adherence) CD4+ T-cell count and being prescribed concomitant drugs (medications for comorbidities). Of specific drugs investigated, atazanavir, atazanavir/r, fosamprenavir, indinavir, indinavir/r and lopinavir/r were associated with suboptimal adherence and tenofovir disoproxil fumarate/emtricitabine with higher adherence.In this, the largest analysis of ART adherence to date, some protease inhibitor containing regimens and regimens with more than one dose per day were associated with suboptimal adherence.

Accession: 036720786

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