Background: In the North Carolina Department of Corrections protease inhibitors are received via a DOT protocol while other HIV medications are self-administered, also known as keep on person (KOP). Methods: As part of an on going study of antiretroviral adherence, electronic drug monitoring devices (eDEMS) were placed on DOT and KOP bottles of 11 HIV-infected inmate volunteers for 1 month. Medication administration records (MARs) completed by staff to record DOT administration were collected. Adherence was calculated as the % of total prescribed doses that were recorded as taken. Results: A comparison of adherence to KOP as measured by eDEMS with adherence to DOT as measured by both eDEMS and MARs is shown below.
| Subject | DOT MAR | DOT eDEM | KOP eDEM |
| 1 | 100% | 61% | 50% |
| 2 | 98% | 82% | 84% |
| 3 | 79% | 74% | 58% |
| 4 | 93% | 56% | 39% |
| 5 | 86% | 83% | 87% |
| 6 | 99% | 62% | NA |
| 7 | 84% | 72% | NA |
| 8 | 89% | 63% | 65% |
| 9 | 93% | 76% | NA |
| 10 | 99% | 100% | 93% |
| 11 | 89% | 52% | NA |
| Mean | 92% | 71% | 68% |
Learning Objectives: The participants in this session will get a perspective on adherence to antiretroviral therapy among HIV-infected prison inmates receiving directly observed therapy. They will learn that adherence to combination anti-HIV therapy in prison is often sub-optimal and that directly observed therapy does not ensure adequate adherence in this setting. Participants will also learn that medication administration records may overestimate actual adherence. Participants should be able to evaluate adherence to antiretroviral therapy in prison, to assess the pitfalls of adherence measurements that rely on medication administration records, and apply some of these insights to the design of interventions to improve adherence. At the conclusion of this session, the participant will be able to describe the level of adherence to antiretroviral therapy among prison inmates, characterize the effect of directly observed therapy on adherence, and recognize the limitations of medication administration records in assessing adherence
Keywords: Adherence, Prisoners Health Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.