, Volume 10, Issue 3, pp 249-251
Date: 31 May 2006

Monitoring Adherence to HIV Antiretroviral Therapy in Routine Clinical Practice: The Past, the Present, and the Future

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Adherence to antiretroviral therapy is the strongest predictor of viral suppression, drug resistance, disease progression and death in HIV infected individuals (Bangsberg et al., 2000, 2003; Bangsberg, Hecht et al., 2001; Bangsberg, Perry et al., 2001; de Olalla et al., 2002; Hogg et al., 2002; Paterson et al., 2000). There is, however, no standard approach to adherence assessment in routine clinical practice. This situation is analogous to the general internist managing hypertension with out a blood pressure cuff or the critical care specialist managing a ventilator without measures of oxygenation. Worse yet, providers in routine clinical practice have rarely predicted adherence better than random (Bangsberg, Hecht et al., 2001; Bangsberg, Perry et al., 2001; Gross, Bilker, Friedman, Coyne, and Strom, 2002) which means that we are leaving the most critical determinant of HIV treatment outcomes to chance.

In this edition of AIDS and Behavior, Simoni and colleagues conducted a systematic ...