Objective. It is often assumed that adherence to an HIV multi-drug regimen is consistent across medications. This study ascertained the validity of this assumption and determined factors associated with adherence among women in Brooklyn, New York. Methods. Women reporting regimens for over 30 days were interviewed (N=50). Self-report items included drug use, depression (CES-D), and health status (MOS SF-20). Clients were classified as adherent if all doses of ART were taken over a 3 day period. Those who took medications early or late or did not take them according to instruction were classified as having taken ART incorrectly. Results. Eight clients were on dual, 41 on triple, and 1 on quadruple therapy. 62% reported complete adherence. Of these, 45% took at least one dose incorrectly. Adherence varied across antiretrovirals, with correlations ranging from r=.16 to .86. Indinavir had the lowest percentage of those reporting adherence (44%), followed by Saquinavir (60%), Ritonavir (67%), Stavudine (72%), Lamivudine (72%), Nelfinavir (74%), Didanosine (75%), and Nevirapine (78%). In multivariate analysis, lifetime cocaine/injection drug use (OR=6.4) and depression (OR=6.6) were associated (p < .05) with imperfect adherence, while age, health status, CD4 count, and total ART doses daily were not. Conclusions. There was inadequate consistency of ART intake and varied levels of inter-medication correlations, with lower adherence overall to protease inhibitors. Interventions among women living with HIV are necessary to maintain adequate adherence, particularly among those with depression and/or drug use. Medication adherence should be evaluated on a drug by drug basis, rather than as a whole.
Learning Objectives: Identify barriers to HIV therapeutic adherence among women living with HIV disease
Keywords: Adherence, Women and HIV/AIDS
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.