The Dynamic of Adherence to Highly Active Antiretroviral Therapy: Results From the French National APROCO Cohort

Abstract

Adherence behavior is a dynamic process. Continued adherence was associated with better response to therapy and should be encouraged to reduce the risk of virologic failure.

The influence of symptom experiences and attributions on adherence to highly active anti-retroviral therapy (HAART): a six-month prospective, follow-up study

“…There was a significant inverse correlation between changes in symptom experiences and changes in necessity scores over time (HIV-symptoms r=-0.22, p<0.05; HAART symptoms r=- The results are consistent with previous findings linking symptoms to non-adherence to HAART (Ammassari et al, 2001, Carrieri et al, 2001Chesney et al, 2000;Duran et al, 2001;Gifford et al, 2000) and provide further insight into the nature of these relationships.…”

“…Those who provided data were significantly older and more likely to be antiretroviral naïve than the overall study sample. Since younger age (Carrieri et al, 2001;Moatti et al, 2000) and having prior experience of antiretroviral treatment (Duran et al, 2001;Mannheimer et al, 2002) have previously been associated with non-adherence, it is …”

“…It should be noted that symptoms are subjective experiences, and those that are not considered to be clinically significant may be perceived as severe by the patient. Indeed, previous studies found that low adherence was associated with patients' perceptions of symptoms, but not by physician estimates of symptoms (Carrieri et al, 2001;Duran et al, 2001) and that providers underestimated the presence and intensity of symptoms (Justice et al, 1999 The adjusted mean is the value of the group mean adjusted for prior treatment experience, time since diagnosis, baseline depression and adherence at 1M and 3M. …”

Scaling up of highly active antiretroviral therapy in a rural district of Malawi: an effectiveness assessment

“…We obtained a specifi c measure of high adherence with a third combined indicator, using an approach already adopted in studies with a similar way of questioning but based on self-administered questionnaires. 18 From the classifi cation of adherence in the past 4 days, highly adherent patients were reclassifi ed as moderately adherent if they reported to have inadequately followed the prescribed schedule of their prescriptions, or did not report 100% adherence in the previous 28 days on the visual analogue scale. Another estimate of patients' adherence not based on self-report was derived from the examination of patients' pill boxes and the counting of pills actually taken with respect to the number of pills prescribed.…”

The influence of depressive symptoms and substance use on adherence to antiretroviral therapy. A cross-sectional prevalence study

“…9 Additionally, stressful events and trauma have a negative effect on important components of the complex immune system, such as CD4 T cells. 10,11 Since adherence is unstable in situations such as mental conditions 12 with erratic 13 and dynamic courses, 14,15 or is expressed in other forms, such as missed doses or as treatment interruptions, i.e. so-called "drug holidays", 16 early detection of non-adherence may prevent the development of ART resistance and treatment failure.…”