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Measuring Adherence to Antiretroviral Treatment: The Role of Pharmacy Records of Drug Withdrawals

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Abstract

This study aimed to evaluate adherence to antiretroviral treatment (ART) among HIV + adults, assess its association with HIV viral load (VL) and identify factors associated to adherence. A survey involving a random sample of adults followed at a HIV/AIDS reference center in São Paulo city, Brazil, from 2007 to 2009 was done. A questionnaire was applied and data were retrieved from the pharmacy and medical records. The study involved 292 subjects: 70.2% men; median age: 43 years; median duration of ART: 8 years. 89.3% self-reported taken all prescribed pills in the last 3 days but only 39.3% picked up ≥95% of the prescribed ART from the pharmacy in the last 12 months. At the multivariate analysis having symptoms prior to ART, taking fewer ART pills, and not missing medical appointments were independently associated to higher adherence. Adherence was strongly associated with undetectable HIV VL. Rates of undetectable HIV VL did not differ from 80 to ≥95% of adherence.

Resúmen

Este trabajo tuvo como objetivo evaluar en adultos con VIH, la adhesión al tratamiento antiretroviral (TAR), su asociación con la carga viral (CV-VIH) e identificar factores asociados a la adhesión. Se realizó una encuesta a una muestra aleatoria de adultos (N = 292) asistidos por el centro de referencia de VIH/SIDA en la ciudad de San Pablo (2007–2009). Se extrajeron datos de registros médicos y de farmacia. Este estudio comprendió 70,2% hombres; edad media: 43 años; duración media del TAR: 8 años. 89,3% autorelató tomar todas las píldoras prescriptas del TAR en los últimos 3 días; pero sólo 39,3% levantó de la farmacia en los últimos 12 meses, ≥95% de las mismas. En el análisis multivariado, no perderse ninguna cita médica, tener síntomas antes del TAR y tomar menos píldoras se asociaron independientemente a la alta adhesión. Ésta se asoció fuertemente con CV-VIH indetectable, cuyas tasas no difirieron de 80 a 95% de adhesión.

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Acknowledgments

To Claudinei Alves Santana, pharmacist from the Extension Service for Assistance to HIV/AIDS Patients (Serviço de Extensão ao Atendimento a Pacientes HIV/AIDS) for his help with the pharmacy records.

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Authors and Affiliations

  1. Serviço de Extensão ao Atendimento a Pacientes HIV/AIDS, Clínica de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas, São Paulo, Brazil

    Eliana Battaggia Gutierrez, Ana Marli Christovam Sartori, Ana Lucia Schmidt, Roberta Vilela Moreno & Camila de Melo Picone

  2. Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Bruna Mamprim Piloto, Adriana Santos de Oliveira & Adriana Rodrigues Pouza

  3. Faculdade de Ciências Humanas e da Saúde, Pontifícia Universidade Católica de São Paulo, São Paulo, Brazil

    Bruna Biagi França

  4. Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil

    Manoel Carlos Sampaio de Almeida Ribeiro

  5. Rua Miranda Montenegro 162, São Paulo, SP, Brazil

    Eliana Battaggia Gutierrez

Authors
  1. Eliana Battaggia Gutierrez
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  2. Ana Marli Christovam Sartori
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  3. Ana Lucia Schmidt
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  4. Bruna Mamprim Piloto
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  5. Bruna Biagi França
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  6. Adriana Santos de Oliveira
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  7. Adriana Rodrigues Pouza
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  8. Roberta Vilela Moreno
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  9. Camila de Melo Picone
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  10. Manoel Carlos Sampaio de Almeida Ribeiro
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Correspondence to Eliana Battaggia Gutierrez.

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Gutierrez, E.B., Sartori, A.M.C., Schmidt, A.L. et al. Measuring Adherence to Antiretroviral Treatment: The Role of Pharmacy Records of Drug Withdrawals. AIDS Behav 16, 1482–1490 (2012). https://doi.org/10.1007/s10461-012-0168-3

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  • DOI: https://doi.org/10.1007/s10461-012-0168-3

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