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Estimating HIV Medication Adherence and Persistence: Two Instruments for Clinical and Research Use
David A Wohl1, A T Panter2, Christine Kirby3
1Division of Infectious Diseases, The University of North Carolina, Campus Box 7215, Chapel Hill, NC, 27599, USA. wohl@med.unc.edu.
AIDS and Behavior
|April 28, 2017
Summary
Predicting adherence to antiretroviral therapy (ART) is crucial for HIV management. Self-reported barriers and confidence in medication taking effectively predict future non-adherence and non-persistence in patients on ART.
Area of Science:
- Medical Sciences
- Psychology
- Public Health
Background:
- Antiretroviral therapy (ART) is essential for managing HIV but requires lifelong daily adherence.
- Existing predictors of suboptimal ART adherence and persistence are insufficient for individual patient assessment.
- Predicting future medication-taking behaviors is critical for clinical and research applications.
Purpose of the Study:
- To develop and validate instruments for estimating future ART adherence and persistence.
- To identify key factors that predict individual medication-taking behaviors in HIV-infected patients.
Main Methods:
- A 148-item battery was administered to 181 HIV-infected patients.
- ART adherence and persistence were monitored electronically for 3 months.
- Statistical analysis identified predictors of non-adherence and non-persistence.
Main Results:
- Perceived confidence in medication taking and self-reported barriers were the strongest predictors of non-adherence.
- Barriers such as affordability and scheduling strongly predicted non-adherence and short-term non-persistence (3- and 7-day).
- A 10-item battery and a 30-item battery were developed for predicting these outcomes.
Conclusions:
- Self-reported barriers and confidence are key indicators for predicting ART adherence and persistence.
- Validated instruments can help identify individuals at risk for suboptimal ART adherence.
- These tools support clinical and research efforts to improve HIV treatment outcomes.
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