The 130th Annual Meeting of APHA

Abstract #46194

Linda Weiss, PhD¹, Ruth Finkelstein, ScD¹, P. Tyler French, MPH², Mark Waters, RN, MPH³, and Bruce Agins, MD, MPH³. (1) Office of Special Populations, The New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, 212 822 7298, lweiss@nyam.org, (2) Office of Program Evaluation and Research, New York State Department of Health AIDS Institute, 150 Broadway, Menands, NY 12204, (3) Office of the Medical Director, New York State Department of Health AIDS Institute, 5 Penn Plaza, New York, NY 10001

A high level of adherence is a requirement of HAART, impacting on both its therapeutic efficacy and the suppression of resistant strains of HIV. Recognition of factors that discourage adherence can aid providers caring for HIV-infected individuals. Utilizing data from 11 adherence support programs operating in New York State, we examined the association between self-reported side effects and nonadherence at the first 3 follow-up assessments (approximately 3, 6 and 9 months after enrollment in the programs). Reports of side effects were frequent: 74%, 73% and 68% of clients reported at least 1 side effect at the three follow-ups, respectively. Thirty-seven percent, 35%, and 21% reported four or more side effects. In bivariate analysis, total number of side effects was significantly associated with nonadherence at the first and third follow-ups. Individual side effects associated with nonadherence for at least 2 of the 3 follow-ups include fatigue, fever/chills, memory problems, and nausea/vomiting (p<.05 in chi square analysis). In multivariate analysis controlling for previous HAART experience, time since HIV diagnosis, mental health, drug use, age, gender, ethnicity, and education, total number of side effects was significantly associated with nonadherence at the first follow-up. Compared to individuals with no side effects, the odds of missing a dose for those with 1-3 side effects was 2.11(p<.05); for individuals with 9 or more side effects, the odds of a missed dose was 3.43 (p<.05). Assessing side effects is an important component of HIV care. Control of side effects may contribute to improved adherence to HAART.

Learning Objectives:

• Identify commonly reported side effects among people on HAART and the changes in prevalence of side effects over time.
• Explain the relationship between particular side effects and nonadherence.
• Explain the relationship between cumulative number of side effects and nonadherence.
• Describe other factors that affect adherence and how side effects relate to these other factors.

Keywords: Treatment Adherence, HIV/AIDS

Presenting author's disclosure statement:
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.