ObjectivesGiven the importance of adherence to combination antiretroviral therapy (cART) for the reduced morbidity and improved mortality of people living with HIV infection (PLWH), we set out to determine which of a number of previously investigated personal, socioeconomic, treatment-related and disease-related factors were independently associated with self-reported difficulty taking antiretroviral therapy (ART) in an Australian sample of PLWH. MethodsUsing data from a national cross-sectional survey of 1106 PLWH, we conducted bivariate and multivariable analyses to assess the association of over 70 previously investigated factors with selfreported difficulty taking ART. Factors that maintained an association with reported difficulty taking ART at the level of a 5 0.05 in the multivariable logistic regression analysis were considered to be independently associated with reported difficulty taking ART. ResultsA total of 867 (78.4%) survey respondents were taking antiretroviral medication at the time of completing the HIV Futures 6 survey. Overall, 39.1% of these respondents reported difficulty taking ART. Factors found to be independently associated with reported difficulty taking ART included younger age, alcohol and party drug use, poor or fair self-reported health, diagnosis of a mental health condition, living in a regional centre, taking more than one ART dose per day, experiencing physical adverse events or health service discrimination, certain types of ART regimen and specific attitudes towards ART and HIV. ConclusionsThirteen previously investigated factors were found to be independently associated with reported difficulty taking ART, reaffirming the dynamic nature of adherence behaviour and the ongoing importance of addressing adherence behaviour in the clinical management of PLWH.Keywords: adherence, antiretroviral therapy, Australia, HIV, nonadherence IntroductionCombination antiretroviral therapy (cART) has revolutionized the course of HIV disease, transforming HIV infection from a life-threatening infection to a manageable chronic condition, particularly in developed countries [1][2][3]. However, a key challenge is the high level of adherence to cART that is required for viral suppression, immunological response and reduced morbidity and mortality in individuals with HIV/AIDS [4][5][6]. Studies have demonstrated a requirement for adherence levels of at least 95% in order to achieve adequate viral suppression for regimens including unboosted protease inhibitor (PI) therapy [4,7]. While a lower level of adherence has been shown to lead to viral suppression when using nonnucleoside reverse transcriptase inhibitor (NNRTI) regimens [7], the development of treatment-resistant mutations has been shown to peak at approximately 70% adherence and there is an ongoing decline in the rate of developing treatmentresistant mutations towards 100% adherence, providing a DOI: 10.1111/j.1468-1293.2011.00928.x HIV Medicine (2011 r 2011 British HIV Association 562 further imperative for achieving near-perfect adhere...

CASI may be a reliable, efficient and highly acceptable method for the screening of sexual risk in clinical sexual health settings and could be used routinely to improve the efficiency of clinical services.

The main objective of this prospective randomised study was to evaluate whether offering pre-colposcopy group sessions reduces anxiety at the time of colposcopy. We also examined whether this strategy improved knowledge about abnormal smears and colposcopy and improved satisfaction with the colposcopy service provided. One hundred and forty-seven women undergoing colposcopy for the first time were randomised into two groups. The control group (n = 75) received conventional management. The study group (n = 72), in addition to conventional management, were invited to attend a pre-colposcopy group session led by a trained colposcopy nurse. Questionnaires were used to determine state anxiety inventory scores and knowledge scores at the time of randomisation, immediately before colposcopy and 6 weeks after the clinic visit. Satisfaction questionnaires were completed 6 weeks after the clinic visit. We found that women attending colposcopy clinics are anxious. Those women who attended the pre-colposcopy session had improved knowledge scores (P = 0.039) at the time of colposcopy and satisfaction (P = 0.037). However, the intervention failed to significantly reduce anxiety at the time of colposcopy (P > 0.05).

ObjectiveTo identify key relationships between the decision to take a break from antiretroviral treatments and potential clinical and social antecedents. Methods