Current HIV/AIDS Reports

, 5:186 | Cite as

Adherence to biomedical HIV prevention methods: Considerations drawn from HIV treatment adherence research

Article

Abstract

Biomedical approaches to HIV prevention (eg, microbicides, antiretroviral preexposure prophylaxis) are undergoing clinical trials to test their efficacy. One key consideration emerging from completed trials is the critical role of adherence to the investigational product. Suboptimal product adherence may compromise clinical trial results and ultimately undermine the effectiveness of biomedical prevention methods in any future real-world use. Efforts to strengthen biomedical HIV prevention product adherence can benefit from existing research methodologies, findings, and interventions developed for adherence to HIV treatment. Research on treatment adherence is most relevant to medication-based biomedical prevention strategies, such as antiretroviral preexposure prophylaxis and acyclovir for herpes simplex virus-2. Three areas where HIV treatment adherence literature can inform research on such biomedical prevention strategies are 1) specialized methods for assessing medication adherence, 2) research findings emphasizing social context as an adherence determinant, and 3) promising behavioral interventions to improve adherence.

References and Recommended Reading

  1. 1.
    Holtgrave D: Evidence-based efforts to prevent HIV infection: an overview of current status and future challenges. Clin Infect Dis 2007, 45(Suppl 4):S293–S299.PubMedCrossRefGoogle Scholar
  2. 2.
    Green EC, Halperin DT, Natulya V, Hogle JA: Uganda’s HIV prevention success: the role of sexual behavior change and the national response. AIDS Behav 2006, 10:335–346.PubMedCrossRefGoogle Scholar
  3. 3.
    Gray RH, Kigozi G, Serwadda D, et al.: Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet 2007, 369:657–666.PubMedCrossRefGoogle Scholar
  4. 4.
    Padian NS, van der Straten A, Ramjee G, et al.: Diaphragm and lubricant gel for prevention of HIV acquisition in southern African women: a randomised controlled trial. Lancet 2007, 370:251–261.PubMedCrossRefGoogle Scholar
  5. 5.
    Watson-Jones D, Weiss HA, Rusizoka M, et al.: Effect of herpes simplex suppression on incidence of HIV among women in Tanzania. N Engl J Med 2008, 358:1560–1571.PubMedCrossRefGoogle Scholar
  6. 6.
    Cohen J: Microbicide fails to protect against HIV. Science 2008, 319:1026–1027.PubMedCrossRefGoogle Scholar
  7. 7.
    Peterson L, Taylor D, Roddy R, et al.: Tenofovir disoproxil fumarate for prevention of HIV infection in women: a phase 2, double-blind, randomized, placebo-controlled trial. PLoS Clin Trials 2007, 2:e27.PubMedCrossRefGoogle Scholar
  8. 8.
    Lagakos SW, Gable AR, eds: Methodological Challenges in Biomedical HIV Prevention Trials. Washington DC: National Academies Press; 2008.Google Scholar
  9. 9.
    Giordano TP, Gifford AL, White AC, et al.: Retention in care: a challenge to survival with HIV infection. Clin Infect Dis 2007, 44:1493–1499.PubMedCrossRefGoogle Scholar
  10. 10.
    Stirratt MJ, Gordon CM: HIV treatment adherence research and intervention: current advances and future challenges. J HIV/AIDS Soc Serv 2007, 6:9–22.CrossRefGoogle Scholar
  11. 11.
    Bradford JB: The promise of outreach for engaging and retaining out-of-care persons in HIV medical care. AIDS Patient Care STDS 2007, 21(Suppl 1):S85–S91.PubMedGoogle Scholar
  12. 12.
    Fisher M: Late diagnosis of HIV infection: major consequences and missed opportunities. Curr Opin Infect Dis 2008, 21:1–3.PubMedGoogle Scholar
  13. 13.
    Branson BJ: Current HIV epidemiology and revised recommendations for HIV testing in health-care settings. Med Virol 2007, 79(Suppl 1):S6–S10.CrossRefGoogle Scholar
  14. 14.
    Gao X, Nau DP, Rosenbluth SA, et al.: The relationship of disease severity, health beliefs and medication adherence among HIV patients. AIDS Care 2000, 12:387–398.PubMedCrossRefGoogle Scholar
  15. 15.
    Arnsten JH, Demas PA, Farzadegan H, et al.: Antiretroviral therapy adherence and viral suppression in HIV-infected drug users: comparison of self-report and electronic monitoring. Clin Infect Dis 2001, 33:1417–1423.PubMedCrossRefGoogle Scholar
  16. 16.
    Miller LG, Hays RD: Measuring adherence to antiretroviral medications in clinical trials. HIV Clin Trials 2000, 1:36–46.PubMedCrossRefGoogle Scholar
  17. 17.
    Bell DJ, Kapitao Y, Sikwese R, et al.: Adherence to antiretroviral therapy in patients receiving free treatment from a government hospital in Blantyre, Malawi. J Acquir Immune Defic Syndr 2007, 45:560–563.PubMedCrossRefGoogle Scholar
  18. 18.
    Chesney MA: The elusive gold standard. Future perspectives for HIV adherence assessment and intervention. J Acquir Immune Defic Syndr 2006, 43(Suppl 1):S149–S155.PubMedGoogle Scholar
  19. 19.
    Simoni JM, Kurth AE, Pearson, CR, et al.: Self-report measures of antiretroviral therapy adherence: a review with recommendations for HIV research and clinical management. AIDS Behav 2006, 10:227–245.PubMedCrossRefGoogle Scholar
  20. 20.
    Bangsberg DR, Bronstone A, Chesney MA, Hecht FM: Computer-assisted self-interviewing (CASI) to improve provider assessment of adherence in routine clinical practice. J Acquir Immune Defic Syndr 2002, 31(Suppl 3):S107–S111.PubMedGoogle Scholar
  21. 21.
    Chesney MA, Ickovics JR, Chambers DB, et al.: Selfreported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. AIDS Care 2000, 12:255–266.PubMedCrossRefGoogle Scholar
  22. 22.
    Lu M, Safren SA, Skolnik PR, et al.: Optimal recall period and response task for self-reported HIV medication adherence. AIDS Behav 2008, 12:86–94.PubMedCrossRefGoogle Scholar
  23. 23.
    Kalichman SC, Cain D, Fuhrel A, et al.: Assessing medication adherence self-efficacy among low-literacy patients: development of a pictographic visual analogue scale. Health Educ Res 2004, 20:24–35.PubMedCrossRefGoogle Scholar
  24. 24.
    Oyugi JH, Byakika-Tusiime J, Charlebois ED, et al.: Multiple validated measures of adherence indicate high levels of adherence to generic HIV antiretroviral therapy in a resource-limited setting. J Acquir Immune Defic Syndr 2004, 36:1100–1102.PubMedCrossRefGoogle Scholar
  25. 25.
    Hogarty K, Kasowitz A, Herold BC, Keller MJ: Assessment of adherence to product dosing in a pilot microbicide study. Sex Transm Dis 2007, 34:1000–1003.PubMedGoogle Scholar
  26. 26.
    Bangsberg DR, Hecht FM, Charlebois ED, et al.: Comparing objective measures of adherence to HIV antiretroviral therapy: electronic medication monitors and unannounced pill counts. AIDS Behav 2001, 5:275–281.CrossRefGoogle Scholar
  27. 27.
    Kalichman SC, Amarai CM, Stearns H, et al.: Adherence to antiretroviral therapy assessed by unannounced pill counts conducted by telephone. J Gen Int Med 2007, 22:1003–1006.CrossRefGoogle Scholar
  28. 28.
    Liu H, Golin CE, Miller LG, et al.: A comparison study of multiple measures of adherence to HIV protease inhibitors. Ann Intern Med 2001, 134:968–977.PubMedGoogle Scholar
  29. 29.
    Mills EJ, Nachega JB, Buchan I, et al.: Adherence to antiretroviral therapy in sub-Saharan Africa and North America: a meta-analysis. JAMA 2006, 296:679–690.PubMedCrossRefGoogle Scholar
  30. 30.
    Bangsberg DR, Ware N, Simoni J: Adherence without access to antiretroviral therapy in sub-Saharan Africa? AIDS 2006, 20:140–141.PubMedCrossRefGoogle Scholar
  31. 31.
    Johnson KE, Quinn TC: Update on male circumcision: prevention success and challenges ahead. Curr Infect Dis Rep 2008, 10:243–251.PubMedCrossRefGoogle Scholar
  32. 32.
    Oyugi JH, Byakika-Tusiime J, Ragland K, et al.: Treatment interruptions predict resistance in HIV-positive individuals purchasing fixed-dose combination antiretroviral therapy in Kampala, Uganda. AIDS 2007, 21:965–971.PubMedCrossRefGoogle Scholar
  33. 33.
    Ware NC, Wyatt MA, Tugenberg T: Social relationships, stigma and adherence to antiretroviral therapy for HIV/AIDS. AIDS Care 2006, 18:904–910.PubMedCrossRefGoogle Scholar
  34. 34.
    Ramadhani HO, Thielman NM, Landman KZ, et al.: Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania. Clin Infect Dis 2007, 45:1492–1498.PubMedCrossRefGoogle Scholar
  35. 35.
    Behforouz HL, Farmer PE, Mukherjee JS: From directly observed therapy to accompagnateurs: enhancing AIDS treatment outcomes in Haiti and in Boston. Clin Infect Dis 2004, 38(Suppl 5):S429–S436.PubMedCrossRefGoogle Scholar
  36. 36.
    Simoni JM, Pearson CR, Pantalone DW, et al.: Efficacy of interventions in improving highly active antiretroviral therapy adherence and HIV-1 RNA viral load: a meta-analytic review of randomized controlled trials. J Acquir Immune Defic Synd 2006, 43(Suppl 1):S23–S35.CrossRefGoogle Scholar
  37. 37.
    Pradier C, Bentz L, Spire B, et al.: Efficacy of an educational and counseling intervention on adherence to highly active antiretroviral therapy: French prospective controlled study. HIV Clin Trials 2003, 4:121–131.PubMedCrossRefGoogle Scholar
  38. 38.
    Reynolds NR, Testa MA, Su M, et al.: Telephone support to improve antiretroviral medication adherence: a multisite, randomized controlled trial. J Acquir Immune Defic Synd 2008, 47:62–68.Google Scholar
  39. 39.
    Petersen ML, Wang Y, van der Laan MJ, et al.: Pillbox organizers are associated with improved adherence to HIV antiretroviral therapy and viral suppression: a marginal structural model analysis. Clin Infect Dis 2007, 45:908–915.PubMedCrossRefGoogle Scholar
  40. 40.
    Celum C, Wald A, Hughes J, et al.: Effect of aciclovir on HIV-1 acquisition in herpes simplex virus 2 seropositive women and men who have sex with men: a randomised, double-blind, placebo-controlled trial. Lancet 2008, 371:2109–2119.PubMedCrossRefGoogle Scholar
  41. 41.
    Remien RH, Stirratt MJ, Dolezal C, et al.: Couple-focused support to improve HIV medication adherence: a randomized controlled trial. AIDS 2005, 19:807–814.PubMedCrossRefGoogle Scholar
  42. 42.
    Rosen MI, Dieckhaus K, McMahon TJ, et al.: Improved adherence with contingency management. AIDS Patient Care STDS 2007, 21:30–40.PubMedCrossRefGoogle Scholar
  43. 43.
    Williams AB, Fennie KP, Bova CA, et al.: Home visits to improve adherence to highly active antiretroviral therapy: a randomized controlled trial. J Acquir Immune Defic Syndr 2007, 42:314–321.Google Scholar
  44. 44.
    Pearson CR, Micek MA, Simoni JM, et al.: Randomized control trial of peer-delivered, modified directly observed therapy for HAART in Mozambique. J Acquir Immune Defic Syndr 2007, 46:238–244.PubMedCrossRefGoogle Scholar
  45. 45.
    Goggin K, Liston RJ, Mitty JA: Modified directly observed therapy for antiretroviral therapy: a primer from the field. Public Health Rep 2007, 122:472–481.PubMedGoogle Scholar
  46. 46.
    Gray RH, Wawer MJ: Randomised trials of HIV prevention. Lancet 2007, 370:200–201.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2008

Authors and Affiliations

  1. 1.Center for Mental Health Research on AIDSNational Institute of Mental HealthBethesdaUSA

Personalised recommendations