Insights on GRACE (Gender, Race, And Clinical Experience) from the Patient's Perspective: GRACE Participant Survey

Abstract

The Gender, Race And Clinical Experience (GRACE) study was conducted between October 2006 and December 2008 to evaluate sex-and race-based differences in outcomes after treatment with a darunavir/ritonavir-based antiretroviral regimen. Between June 2010 and June 2011, former participants of the GRACE trial at participating sites were asked to complete a 40-item questionnaire as part of the GRACE Participant Survey study, with a primary objective of assessing patients' characteristics, experiences, and opinions about participation in GRACE. Of 243 potential survey respondents, 151 (62%) completed the survey. Respondents were representative of the overall GRACE population and were predominantly female (64%); fewer were black, and more reported recreational drug use compared with nonrespondents (55% vs. 62% and 17% vs. 10%, respectively). Access to treatment (41%) and too many blood draws (26%) were reported as the best and worst part of GRACE, respectively. Support from study site staff was reported as the most important factor in completing the study (47%). Factors associated with nonadherence, study discontinuation, and poor virologic response in univariate analyses were being the primary caregiver for children, unemployment, and transportation difficulties, respectively. Patients with these characteristics may be at risk of poor study outcomes and may benefit from additional adherence and retention strategies in future studies and routine clinical care.

Prevalence and Risk Factors Associated with Adherence to Antiretroviral Therapy in HIV-Infected Adults in a Tertiary Care Hospital in Mexico

“…Our results are similar to those of some clinical trials when they found a higher frequency of virological failure in women, factors associated with non-adherence, antiretroviral discontinuation, and poor virologic response in univariate analyses were being the primary caregiver for children, unemployment, and transportation difficulties, respectively, and the major sex-based differences in response may be due to higher discontinuation rates in women [17,18].…”

“…In Mexico, studies conducted in the north of the country in 2006 by Peñarrieta et al and Piña-López et al reported different rates of adherence (50-52%). These used the adherence questionnaire VPAD24 [12,17]. In our study, we decided to use the SMAQ questionnaire because it is easier to use, with a sensitivity of 72% and specificity of 91% [13].…”

Caregivers’ Support Network Characteristics Associated with Viral Suppression among HIV Care Recipients

“…These findings correspond with results from the Gender, Race and Clinical Experience (GRACE) trial that found lower adherence and virologic response among PLHIV who were female and the primary caregivers of children (41). HIV care and support services do not typically address competing childcare, or any caregiving needs and responsibilities of PLHIV or their caregivers, though they may impede health behaviors and affect poor health outcomes.…”

Does gender or mode of HIV acquisition affect virological response to modern antiretroviral therapy (ART)?

“…The study also found that a woman's age at the time she was pregnant was an important predictor of compliance to ART, with younger women experiencing virological failure more frequently [15]. The Gender, Race and Clinical Experience (GRACE) study found that being the primary caregiver for children was associated with poorer compliance with ART [16].…”