, Volume 5, Issue 4, pp 371-378

Prescription of and Adherence to Antiretroviral Therapy Among Women with AIDS

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Abstract

The benefits of antiretroviral therapy (ART) in reducing the risks of AIDS-associated morbidity and mortality are dependent on rigorous adherence to prescription. We assessed patient self-reported prescription of ART, adherence to prescribed medications, and factors related to prescription and adherence among participants in 2 cohort studies of HIV infection in women. Four hundred fifty-three HIV-seropositive women with advanced HIV disease were enrolled in this cross-sectional study and were interviewed between December 1996 and December 1997. Eighty-two percent of women reported ART prescription within the past 6 months; of these, 88% reported combination therapy and 60% use of protease inhibitors. Seventy-seven percent of women reporting ART prescription reported adherence with prescription in the prior 2 weeks either as frequently as prescribed or almost all the time (>75% of the time). Reported reasons for nonadherence included forgetting to take medication and unpleasant side effects. Women with CD4+ lymphocyte counts ≥200/mm3 at interview were more likely to report adherence, as were women with HIV viral load values below detectable limits. Depressive symptoms were prevalent among participants and were significantly associated with poorer adherence. Improvement in adherence may require increased diagnosis and treatment of these symptoms.