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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Factors Associated With Adherence Amongst 5295 People Receiving Antiretroviral Therapy as Part of an International Trial</title>
<author><name sortKey="O Connor, Jemma L" sort="O Connor, Jemma L" uniqKey="O Connor J" first="Jemma L." last="O'Connor">Jemma L. O'Connor</name>
<affiliation><nlm:aff id="af1"><addr-line>Research Department of Infection and Population Health</addr-line>
,<institution>University College London</institution>
,<country>United Kingdom</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gardner, Edward M" sort="Gardner, Edward M" uniqKey="Gardner E" first="Edward M." last="Gardner">Edward M. Gardner</name>
<affiliation><nlm:aff id="af2"><institution>Denver Public Health</institution>
,<addr-line>Colorado</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mannheimer, Sharon B" sort="Mannheimer, Sharon B" uniqKey="Mannheimer S" first="Sharon B." last="Mannheimer">Sharon B. Mannheimer</name>
<affiliation><nlm:aff id="af3"><addr-line>Department of Medicine</addr-line>
,<institution>Harlem Hospital, Columbia University College of Physicians and Surgeons</institution>
,<addr-line>New York</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lifson, Alan R" sort="Lifson, Alan R" uniqKey="Lifson A" first="Alan R." last="Lifson">Alan R. Lifson</name>
<affiliation><nlm:aff id="af4"><addr-line>Division of Epidemiology and Community Health, School of Public Health</addr-line>
,<institution>University of Minnesota</institution>
,<addr-line>Minneapolis</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Esser, Stefan" sort="Esser, Stefan" uniqKey="Esser S" first="Stefan" last="Esser">Stefan Esser</name>
<affiliation><nlm:aff id="af5"><addr-line>Department of Dermatology and Venereology</addr-line>
,<institution>HIV/STD Center, University Hospital Essen</institution>
,<country>Germany</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Telzak, Edward E" sort="Telzak, Edward E" uniqKey="Telzak E" first="Edward E." last="Telzak">Edward E. Telzak</name>
<affiliation><nlm:aff id="af6"><addr-line>Department of Medicine</addr-line>
,<institution>Bronx Lebanon Hospital Center, Albert Einstein College of Medicine</institution>
,<addr-line>New York</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Phillips, Andrew N" sort="Phillips, Andrew N" uniqKey="Phillips A" first="Andrew N." last="Phillips">Andrew N. Phillips</name>
<affiliation><nlm:aff id="af1"><addr-line>Research Department of Infection and Population Health</addr-line>
,<institution>University College London</institution>
,<country>United Kingdom</country>
</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">23204161</idno>
<idno type="pmc">3666133</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666133</idno>
<idno type="RBID">PMC:3666133</idno>
<idno type="doi">10.1093/infdis/jis731</idno>
<date when="2012">2012</date>
<idno type="wicri:Area/Pmc/Corpus">001697</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001697</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Factors Associated With Adherence Amongst 5295 People Receiving Antiretroviral Therapy as Part of an International Trial</title>
<author><name sortKey="O Connor, Jemma L" sort="O Connor, Jemma L" uniqKey="O Connor J" first="Jemma L." last="O'Connor">Jemma L. O'Connor</name>
<affiliation><nlm:aff id="af1"><addr-line>Research Department of Infection and Population Health</addr-line>
,<institution>University College London</institution>
,<country>United Kingdom</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gardner, Edward M" sort="Gardner, Edward M" uniqKey="Gardner E" first="Edward M." last="Gardner">Edward M. Gardner</name>
<affiliation><nlm:aff id="af2"><institution>Denver Public Health</institution>
,<addr-line>Colorado</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Mannheimer, Sharon B" sort="Mannheimer, Sharon B" uniqKey="Mannheimer S" first="Sharon B." last="Mannheimer">Sharon B. Mannheimer</name>
<affiliation><nlm:aff id="af3"><addr-line>Department of Medicine</addr-line>
,<institution>Harlem Hospital, Columbia University College of Physicians and Surgeons</institution>
,<addr-line>New York</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lifson, Alan R" sort="Lifson, Alan R" uniqKey="Lifson A" first="Alan R." last="Lifson">Alan R. Lifson</name>
<affiliation><nlm:aff id="af4"><addr-line>Division of Epidemiology and Community Health, School of Public Health</addr-line>
,<institution>University of Minnesota</institution>
,<addr-line>Minneapolis</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Esser, Stefan" sort="Esser, Stefan" uniqKey="Esser S" first="Stefan" last="Esser">Stefan Esser</name>
<affiliation><nlm:aff id="af5"><addr-line>Department of Dermatology and Venereology</addr-line>
,<institution>HIV/STD Center, University Hospital Essen</institution>
,<country>Germany</country>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Telzak, Edward E" sort="Telzak, Edward E" uniqKey="Telzak E" first="Edward E." last="Telzak">Edward E. Telzak</name>
<affiliation><nlm:aff id="af6"><addr-line>Department of Medicine</addr-line>
,<institution>Bronx Lebanon Hospital Center, Albert Einstein College of Medicine</institution>
,<addr-line>New York</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Phillips, Andrew N" sort="Phillips, Andrew N" uniqKey="Phillips A" first="Andrew N." last="Phillips">Andrew N. Phillips</name>
<affiliation><nlm:aff id="af1"><addr-line>Research Department of Infection and Population Health</addr-line>
,<institution>University College London</institution>
,<country>United Kingdom</country>
</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">The Journal of Infectious Diseases</title>
<idno type="ISSN">0022-1899</idno>
<idno type="eISSN">1537-6613</idno>
<imprint><date when="2012">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p><bold><italic>Background.</italic>
</bold>
We assessed factors associated with antiretroviral therapy (ART) adherence, including specific ART medications.</p>
<p><bold><italic>Methods.</italic>
</bold>
The Strategies for Management of Antiretroviral Therapy study was an international antiretroviral therapy (ART) strategy trial that compared intermittent ART, using CD4<sup>+</sup>
T-cell count as a guide, to continuous ART. Adherence during the 7 days before each visit was measured using self-report. We defined high adherence as self-report of taking “all” pills for each prescribed ART medication; all other reports were defined as suboptimal adherence. Factors associated with adherence were assessed using logistic regression with generalized estimating equations.</p>
<p><bold><italic>Results.</italic>
</bold>
Participants reported suboptimal adherence at 6016 of 35 695 study visits (17%). Factors independently associated with suboptimal adherence were black race, protease inhibitor–containing regimens, greater pill burden, higher maximum number of doses per day, and smoking. Factors independently associated with higher adherence were older age, higher education, region of residence, episodic treatment, higher latest (at the time of adherence) CD4<sup>+</sup>
T-cell count, and being prescribed concomitant drugs (ie, medications for comorbidities). Of specific drugs investigated, atazanavir, atazanavir/ritonavir, fosamprenavir, indinavir, indinavir/ritonavir, and lopinavir/ritonavir were associated with suboptimal adherence, and tenofovir disoproxil fumarate/emtricitabine was associated with higher adherence.</p>
<p><bold><italic>Conclusions.</italic>
</bold>
In this, the largest analysis of ART adherence to date, some protease inhibitor–containing regimens and regimens with >1 dose per day were associated with suboptimal adherence.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Infect. Dis</journal-id>
<journal-id journal-id-type="publisher-id">jid</journal-id>
<journal-id journal-id-type="hwp">jinfdis</journal-id>
<journal-title-group><journal-title>The Journal of Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">0022-1899</issn>
<issn pub-type="epub">1537-6613</issn>
<publisher><publisher-name>Oxford University Press</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23204161</article-id>
<article-id pub-id-type="pmc">3666133</article-id>
<article-id pub-id-type="doi">10.1093/infdis/jis731</article-id>
<article-id pub-id-type="publisher-id">jis731</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Major Articles and Brief Reports</subject>
<subj-group subj-group-type="heading"><subject>HIV/AIDS</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Factors Associated With Adherence Amongst 5295 People Receiving Antiretroviral Therapy as Part of an International Trial</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>O'Connor</surname>
<given-names>Jemma L.</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gardner</surname>
<given-names>Edward M.</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mannheimer</surname>
<given-names>Sharon B.</given-names>
</name>
<xref ref-type="aff" rid="af3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lifson</surname>
<given-names>Alan R.</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Esser</surname>
<given-names>Stefan</given-names>
</name>
<xref ref-type="aff" rid="af5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Telzak</surname>
<given-names>Edward E.</given-names>
</name>
<xref ref-type="aff" rid="af6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Phillips</surname>
<given-names>Andrew N.</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><collab>for the INSIGHT SMART Study Group</collab>
</contrib>
</contrib-group>
<aff id="af1"><label>1</label>
<addr-line>Research Department of Infection and Population Health</addr-line>
,<institution>University College London</institution>
,<country>United Kingdom</country>
</aff>
<aff id="af2"><label>2</label>
<institution>Denver Public Health</institution>
,<addr-line>Colorado</addr-line>
</aff>
<aff id="af3"><label>3</label>
<addr-line>Department of Medicine</addr-line>
,<institution>Harlem Hospital, Columbia University College of Physicians and Surgeons</institution>
,<addr-line>New York</addr-line>
</aff>
<aff id="af4"><label>4</label>
<addr-line>Division of Epidemiology and Community Health, School of Public Health</addr-line>
,<institution>University of Minnesota</institution>
,<addr-line>Minneapolis</addr-line>
</aff>
<aff id="af5"><label>5</label>
<addr-line>Department of Dermatology and Venereology</addr-line>
,<institution>HIV/STD Center, University Hospital Essen</institution>
,<country>Germany</country>
</aff>
<aff id="af6"><label>6</label>
<addr-line>Department of Medicine</addr-line>
,<institution>Bronx Lebanon Hospital Center, Albert Einstein College of Medicine</institution>
,<addr-line>New York</addr-line>
</aff>
<author-notes><corresp>Correspondence: Jemma O'Connor, MSc, Research Department of Infection and Population Health, UCL Royal Free Campus, Rowland Hill St, London NW3 2PF, United Kingdom (<email>jemma.o'connor@ucl.ac.uk</email>
).</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>1</day>
<month>7</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="epub"><day>29</day>
<month>11</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>1</day>
<month>7</month>
<year>2014</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and 0 days and was based on the
. </pmc-comment>
<volume>208</volume>
<issue>1</issue>
<fpage>40</fpage>
<lpage>49</lpage>
<history><date date-type="received"><day>7</day>
<month>6</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>17</day>
<month>9</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>© The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: <email>journals.permissions@oup.com</email>
.</copyright-statement>
<copyright-year>2013</copyright-year>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="jis731.pdf"></self-uri>
<abstract><p><bold><italic>Background.</italic>
</bold>
We assessed factors associated with antiretroviral therapy (ART) adherence, including specific ART medications.</p>
<p><bold><italic>Methods.</italic>
</bold>
The Strategies for Management of Antiretroviral Therapy study was an international antiretroviral therapy (ART) strategy trial that compared intermittent ART, using CD4<sup>+</sup>
T-cell count as a guide, to continuous ART. Adherence during the 7 days before each visit was measured using self-report. We defined high adherence as self-report of taking “all” pills for each prescribed ART medication; all other reports were defined as suboptimal adherence. Factors associated with adherence were assessed using logistic regression with generalized estimating equations.</p>
<p><bold><italic>Results.</italic>
</bold>
Participants reported suboptimal adherence at 6016 of 35 695 study visits (17%). Factors independently associated with suboptimal adherence were black race, protease inhibitor–containing regimens, greater pill burden, higher maximum number of doses per day, and smoking. Factors independently associated with higher adherence were older age, higher education, region of residence, episodic treatment, higher latest (at the time of adherence) CD4<sup>+</sup>
T-cell count, and being prescribed concomitant drugs (ie, medications for comorbidities). Of specific drugs investigated, atazanavir, atazanavir/ritonavir, fosamprenavir, indinavir, indinavir/ritonavir, and lopinavir/ritonavir were associated with suboptimal adherence, and tenofovir disoproxil fumarate/emtricitabine was associated with higher adherence.</p>
<p><bold><italic>Conclusions.</italic>
</bold>
In this, the largest analysis of ART adherence to date, some protease inhibitor–containing regimens and regimens with >1 dose per day were associated with suboptimal adherence.</p>
</abstract>
<kwd-group><kwd>antiretroviral drugs</kwd>
<kwd>adherence</kwd>
<kwd>self-report</kwd>
<kwd>HIV infection</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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