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Longitudinal analysis of patterns and predictors of changes in self-reported adherence to antiretroviral therapy: Swiss HIV Cohort Study

Glass, Tracy R.
Battegay, Manuel
Cavassini, Matthias
De Geest, Sabina
Furrer, Hansjakob
Vernazza, Pietro L.
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Published in Journal of acquired immune deficiency syndromes. 2010, vol. 54, no. 2, p. 197-203
Abstract BACKGROUND: Adherence to combination antiretroviral therapy (cART) is a dynamic process, however, changes in adherence behavior over time are insufficiently understood. METHODS: Data on self-reported missed doses of cART was collected every 6 months in Swiss HIV Cohort Study participants. We identified behavioral groups associated with specific cART adherence patterns using trajectory analyses. Repeated measures logistic regression identified predictors of changes in adherence between consecutive visits. RESULTS: Six thousand seven hundred nine individuals completed 49,071 adherence questionnaires [median 8 (interquartile range: 5-10)] during a median follow-up time of 4.5 years (interquartile range: 2.4-5.1). Individuals were clustered into 4 adherence groups: good (51.8%), worsening (17.4%), improving (17.6%), and poor adherence (13.2%). Independent predictors of worsening adherence were younger age, basic education, loss of a roommate, starting intravenous drug use, increasing alcohol intake, depression, longer time with HIV, onset of lipodystrophy, and changing care provider. Independent predictors of improvements in adherence were regimen simplification, changing class of cART, less time on cART, and starting comedications. CONCLUSIONS: Treatment, behavioral changes, and life events influence patterns of drug intake in HIV patients. Clinical care providers should routinely monitor factors related to worsening adherence and intervene early to reduce the risk of treatment failure and drug resistance.
Keywords AdultAge FactorsAnti-HIV Agents/*therapeutic useEducational StatusFemaleHIV Infections/drug therapy/*psychologyHumansLongitudinal StudiesMaleMedication Adherence/psychology/*statistics & numerical dataMiddle AgedQuestionnairesRisk FactorsSex FactorsSwitzerland/epidemiology
PMID: 20035231
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Research group Unité HIV (46)
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GLASS, Tracy R. et al. Longitudinal analysis of patterns and predictors of changes in self-reported adherence to antiretroviral therapy: Swiss HIV Cohort Study. In: Journal of acquired immune deficiency syndromes, 2010, vol. 54, n° 2, p. 197-203. doi: 10.1097/QAI.0b013e3181ca48bf https://archive-ouverte.unige.ch/unige:20968

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Deposited on : 2012-05-23

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