Background: Adherence is of paramount significance to obtain success with highly active antiretroviral therapy (HAART), however measurement is difficult in practice. Few initiatives have been taken to study adherence patterns in patients at CHC's.
Methods: We developed and piloted a brief, low literacy, self-administered adherence measurement tool given to a sample of patients receiving HIV primary care at Dimock CHC, Roxbury, Massachusetts. Patient self-report was compared to prescribed HAART and viral load (VL) within one-month of questionnaire completion.
Results: Participants (n=48) were 42% female, 77% minority, and 38% had a history of intravenous drug use. Two categories of non-adherence were identified: systemic (SNA: not taking correct dose or frequency)and intermittent (INA: missing a dose periodically). SNA was reported by 34% of patients, with 44% VL below detectable level (BDL) compared with 68% of patients BDL that were not SNA (p=.11). INA, reported by 55% of patients, didn't produce significant findings correlated with viral suppression. Women were more likely to report INA, but no more likely to report SNA or to not achieve BDL. Race, age and drug use weren't predictive of non-adherence or viral suppression.
Conclusions: High levels of systemic and intermittent non-adherence were reported using this pilot tool. Systemic adherence, patients who take their medication as prescribed, correlated with viral suppression; results were limited by the small sample size. These levels of both INA and SNA suggest the need for more initiatives to improve adherence in these populations, and further research is planned using this patient-friendly adherence assessment tool.
Learning Objectives: At the conclusion of this presentation, the partcipant in this session will be able to: 1. Articulate different patterns of non-adherence and explore the associated impact on viral suppression. 2. Describe a low-literacy adherence measurement tool. 3. Discuss data presented from a pilot adherence study from an inner-city community health center.
Keywords: Adherence, HIV Interventions
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.