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AIDS and Behavior

, Volume 14, Issue 4, pp 785–793 | Cite as

Importance of Dose Timing to Achieving Undetectable Viral Loads

  • Christopher J. Gill
  • Lora L. Sabin
  • Davidson H. Hamer
  • Xu Keyi
  • Zhang Jianbo
  • Tao Li
  • Wan-Ju Wu
  • Ira B. Wilson
  • Mary Bachman DeSilva
Original Paper

Abstract

Little is known about the importance of dose timing to successful antiretroviral therapy (ART). In a cohort comprised of Chinese HIV/AIDS patients, we measured adherence among subjects for 6 months using three methods in parallel: self-report using a visual analog scale (SR-VAS), pill count, and electronic drug monitors (EDM). We calculated two adherence metrics using the EDM data. The first metric used the proportion of doses taken; the second metric credited doses as adherent only if taken within a 1-h window of a pre-specified dose time (EDM ‘proportion taken within dose time’). Of the adherence measures, EDM had the strongest associations with viral suppression. Of the two EDM metrics, incorporating dose timing had a stronger association with viral suppression. We conclude that dose timing is also an important determinant of successful ART, and should be considered as an additional dimension to overall adherence.

Keywords

HIV/AIDS Antiretroviral therapy Adherence Dose timing China Non nucleoside reverse transcriptase inhibitor 

Notes

Acknowledgments

This work was supported by a cooperative agreement (GHS-A-00-03-00030-00) between Boston University and the Office of Health and Nutrition of the United States Agency for International Development (USAID), with additional support from the World Health Organization (WHO) and CDC-GAP/China. Dr. Gill’s work was supported by NIH/NIAID K23 AI 62208. We wish to thank Mary Jordan and Lois Bradshaw at USAID, Jonathan Simon, Donald Thea, Deirdre Pierotti at Boston University, our Boston-based project managers Mini Singh and Anna Knapp, our Chinabased field managers James Chen, Guo Jinhua, and Matt Bobo, Cheng Feng at FHI, Ray Yip at CDC-GAP, and Connie Osborne at the WHO-Beijing office.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Christopher J. Gill
    • 1
    • 2
  • Lora L. Sabin
    • 1
  • Davidson H. Hamer
    • 1
    • 2
  • Xu Keyi
    • 3
  • Zhang Jianbo
    • 4
  • Tao Li
    • 1
  • Wan-Ju Wu
    • 1
  • Ira B. Wilson
    • 5
  • Mary Bachman DeSilva
    • 1
  1. 1.Center for International Health and DevelopmentBoston University of Public HealthBostonUSA
  2. 2.Infectious Diseases Section, Department of MedicineBoston University School of MedicineBostonUSA
  3. 3.Department of Sexually Transmitted Diseases and DermatologyDitan HospitalBeijingChina
  4. 4.Department of Sexually Transmitted Diseases and DermatologyDali Second People’s HospitalDaliChina
  5. 5.Institute for Clinical Research and Health Policy StudiesTufts-New England Medical CenterBostonUSA

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