Adherence Profiles and Therapeutic Responses of Treatment-Naive HIV-Infected Patients Starting Boosted Atazanavir-Based Therapy in the ANRS 134-COPHAR 3 Trial

Parienti, Jean‐Jacques; Barrail-Tran, Aurélie; Duval, Xavier; Nembot, Georges; Descamps, Diane; Vigan, Marie; Vrijens, Bernard; Panhard, Xavière; Taburet, Anne‐Marie; Goujard, Cécile

doi:10.1128/aac.02605-12

Cited by 33 publications

(27 citation statements)

References 42 publications

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“…The first of the three pill counts is used to establish the initial number of pills in possession with the subsequent two pill counts allowing for calculation of adherence, defined as the ratio of pills counted relative to pills prescribed, taking into account the number of pills dispensed. 32,33 Sexual behavior electronic diaries. We used an interactive text-diary assessment to collect daily sexual behavior data.…”

Section: Methodsmentioning

confidence: 99%

HIV Disclosure and Transmission Risks to Sex Partners Among HIV-Positive Men

Kalichman

Cherry

et al. 2016

AIDS Patient Care and STDs

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Disclosure of HIV-positive status to sex partners is critical to protecting uninfected partners. In addition, people living with HIV often risk criminal prosecution when they do not inform sex partners of their HIV status. The current study examined factors associated with nondisclosure of HIV status by men living with HIV in Atlanta, GA (92% African African, mean age = 43.8), who engage in condomless sex with uninfected sex partners. Sexually active HIV-positive men (N = 538) completed daily electronic sexual behavior assessments over the course of 28 days and completed computerized interviews, drug testing, medication adherence assessments, and HIV viral load retrieved from medical records. Results showed that 166 (30%) men had engaged in condomless vaginal or anal intercourse with an HIV-uninfected or unknown HIV status sex partner to whom they had not disclosed their HIV status. Men who engaged in nondisclosed condomless sex were less adherent to their HIV treatment, more likely to have unsuppressed HIV, demonstrated poorer disclosure self-efficacy, enacted fewer risk reduction communication skills, and held more beliefs that people with HIV are less infectious when treated with antiretroviral therapy. We conclude that undisclosed HIV status is common and related to condomless sex with uninfected partners. Men who engage in nondisclosed condomless sex may also be more infectious given their nonadherence and viral load. Interventions are needed in HIV treatment as prevention contexts that attend to disclosure laws and enhance disclosure self-efficacy, improve risk reduction communication skills, and increase understanding of HIV infectiousness.

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Section: Methodsmentioning

confidence: 99%

HIV Disclosure and Transmission Risks to Sex Partners Among HIV-Positive Men

Kalichman

Cherry

et al. 2016

AIDS Patient Care and STDs

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“…Adherence was defined as proportion of doses taken on time, in accordance with our past research (and that of others) showing that on-time adherence predicted undetectable viral load (UDVL) most significantly. 48,49 Accordingly, adherence was defined as: ([number of doses taken ±1 hour of dose time] / [total number of prescribed doses]). Doses taken outside the ±1 hour window were considered non-adherent.…”

Section: Methodsmentioning

confidence: 99%

Improving Adherence to Antiretroviral Therapy With Triggered Real-time Text Message Reminders

Sabin

DeSilva

Gill

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

130

178

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Background Real-time adherence monitoring is now possible through medication storage devices equipped with cellular technology. We assessed the effect of triggered cell phone reminders and counseling utilizing objective adherence data on antiretroviral (ART) adherence among Chinese HIV-infected patients. Methods We provided ART patients in Nanning, China, with a medication device (“Wisepill”) to monitor their ART adherence electronically. After 3 months, we randomized subjects within optimal (≥95%) and suboptimal (<95%) adherence strata to intervention vs. control arms. In months 4–9, intervention subjects received individualized reminders triggered by late dose-taking (no device-opening by 30 minutes past dose time), and counseling using device-generated data. Controls received no reminders or data-informed counseling. We compared post-intervention proportions achieving optimal adherence, mean adherence, and clinical outcomes. Results Of 120 subjects enrolled, 116 (96.7%) completed the trial. Pre-intervention, optimal adherence was similar in intervention vs. control arms (63.5% vs. 58.9%, respectively; p=0.60). In the last intervention month, 87.3% vs. 51.8% achieved optimal adherence (risk ratio (RR) 1.7, 95% Confidence Interval (CI) 1.3–2.2); mean adherence was 96.2% vs. 89.1% (p=0.003). Among pre-intervention suboptimal adherers, 78.3% vs. 33.3% (RR 2.4, CI 1.2–4.5) achieved optimal adherence; mean adherence was 93.3% vs. 84.7% (p=0.039). Proportions were 92.5% and 62.9% among optimal adherers, respectively (RR 1.5, CI 1.1–1.9); mean adherence was 97.8% vs. 91.7% (p=0.028). Post-intervention differences in clinical outcomes were not significant. Conclusion Real-time reminders significantly improved ART adherence in this population. This approach appears promising for managing HIV and other chronic diseases and warrants further investigation and adaptation in other settings.

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“…Adherence was calculated as the mean across antiretroviral medications and across pill counts. For descriptive analyses, suboptimal adherence was categorically defined by 80% of medications taken as prescribed, a level of adherence that places patients at risk for developing HIV treatment resistance (Bangsberg & Deeks, 2002; Lima et al, 2010; Parienti et al, 2013). Continuous adherence values were used as the dependent variable in regression models.…”

Section: Methodsmentioning

confidence: 99%

“…Descriptive analyses first compared participants with less than or equal to 80% adherence to those with adherence greater than 80% (Parienti et al, 2013). Descriptive comparisons were performed for demographic and health characteristics, race-based medical mistrust, and medication beliefs.…”

Section: Methodsmentioning

confidence: 99%

Race-based medical mistrust, medication beliefs and HIV treatment adherence: test of a mediation model in people living with HIV/AIDS

et al. 2016

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Race-based medical mistrust significantly predicts non-adherence to antiretroviral therapy (ART) in people living with HIV. The current study builds on previous research that shows beliefs about medication necessity (i.e., “My medicines protect me from becoming worse”) and concerns (i.e., Having to take my medicines worries me) mediate the association between race-based medical mistrust and medication adherence. Racial and ethnic minority men and women living with HIV and receiving ART (N=178) in a southern US city completed computerized measures of demographic and health characteristics, telephone interviews of race-based medical mistrust and medication beliefs, and unannounced phone-based pill counts for ART adherence. Multiple mediation modeling showed that medical mistrust is related to medication necessity and concerns beliefs and ART adherence. Furthermore, medication necessity beliefs predicted ART adherence. The indirect effect of medical mistrust on adherence through medication necessity beliefs was also significant. Results confirm that medication necessity beliefs, although not concerns beliefs, mediate the association between medical mistrust and ART adherence. Medication necessity beliefs offer a viable target for interventions to improve ART adherence in the context of mistrust that patients may have for medical providers and health care systems.

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Adherence Profiles and Therapeutic Responses of Treatment-Naive HIV-Infected Patients Starting Boosted Atazanavir-Based Therapy in the ANRS 134-COPHAR 3 Trial

Cited by 33 publications

References 42 publications

HIV Disclosure and Transmission Risks to Sex Partners Among HIV-Positive Men

HIV Disclosure and Transmission Risks to Sex Partners Among HIV-Positive Men

Improving Adherence to Antiretroviral Therapy With Triggered Real-time Text Message Reminders

Race-based medical mistrust, medication beliefs and HIV treatment adherence: test of a mediation model in people living with HIV/AIDS

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