Adherence to antiretroviral treatment in patients with HIV in the UK: a study of complexity - AID IMPACT SPECIAL ISSUE

Richard Harding (1)

1 Department of Palliative Care, Policy & Rehabilitation

Adherence to HIV treatment regimes is a core element to viral suppression. Yet measurement of adherence is complex. This study was set up to examine the complexity of adherence measurement and to examine rates of adherence in the presence of complex measurement. 502 consecutive attenders at HIV clinics in the UK (80.5% response rate), provided detailed measurement on adherence in the preceding 7 days, setting out dose adherence, as well as measures of timing and dietary conditions. Although 79.1% reported dose adherence in the previous 7 days, 42.8% had not taken the dose at the correct time, and 27.2% had not taken the dose under the correct circumstances. Using a more complex composite measure of full adherence, rates reduced from 79.1% to 41.5%. Fully adherent significantly more likely to be older (F=7.8, p<0.001), UK born (F=6.8, p=0.03), code ethnicity as white (F=5.3, p=0.07), record higher quality of life (X2=8.7, p=0.01), lower psychological symptoms (X2=15.2, p=0.001) and lower global distress symptoms (X2=6.9, p=0.03). There were no differences according to education, behavioural and attitudinal variables. Fully adherent groups were significantly more likely to be in agreement with their doctor on treatment initiation (X2=6.2 p=0.045), satisfied with the amount of involvement in the decision making process (X2=7.3 p=.026), their wishes were considered (X2=12.5 p=0.002) monitoring of their condition (X2=7.1 p=0.028). Multivariate analysis showed that variables which contributed significantly at a 5% criterion level to complex adherence were physical symptoms (OR=0.56, p = 0.05), psychological symptoms (OR=2.37, p < 0.001).age (OR=0.96, p = 0.02), education (OR=0.54, p = 0.03), having more than one sexual partner (OR=0.46, p = 0.03), having risky sex (OR=4.30, p = 0.002), and being optimistic about treatments (OR=0.42, p = 0.01), The softer markers of adherence are not usually measured in follow up and may account for variations in treatment responses. The complexity of adherence needs to be understood and addressed to maximise treatment efficacy.

Mots clés: Life Sciences

Richard Harding. Adherence to antiretroviral treatment in patients with HIV in the UK: a study of complexity - AID IMPACT SPECIAL ISSUE. AIDS Care, 2008, 20 (04), pp.442-448. ⟨10.1080/09540120701867032⟩. ⟨hal-00513446⟩