Self-Report Measures in the Assessment of Antiretroviral Medication Adherence: Comparison with Medication Possession Ratio and HIV Viral Load

J Int Assoc Provid AIDS Care. 2015 Mar-Apr;14(2):156-62. doi: 10.1177/2325957414557263. Epub 2014 Nov 23.

Abstract

Background: Adherence is a major determinant of the effectiveness of antiretroviral therapy (ART). We determined the association between self-reported adherence (SRA) and medication possession ratio (MPR), a pharmacy-based adherence measure, and their respective associations with viral load.

Methods: Adherence to ART was assessed by MPR over 6 months and by self-report which included a question with a Likert-type scale response, a visual analogue scale (VAS), and an inquiry about the last time the patients skipped any prescribed medications.

Results: Taking MPR as the "gold standard," all 3 SRA measures displayed high specificity but low sensitivity. The prevalence ratio (95% confidence interval) for viral load ≥50 copies/mL was 2.19 (1.07-4.50) for MPR <90%, 1.98 (1.04-3.78) for poor/fair/good versus excellent/very good ability to take antiretroviral drugs, 1.47 (0.79-2.75) for skipping medications within the past 2 weeks, and 2.51 (1.39-4.53) for VAS <95%.

Conclusion: These data suggest various SRA measures hold clinical value in screening for poor ART adherence.

Keywords: HIV; adherence; antiretroviral therapy; medication possession ratio.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Cohort Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • HIV Infections / virology
  • HIV-1 / drug effects
  • HIV-1 / physiology*
  • Humans
  • Male
  • Medication Adherence*
  • Middle Aged
  • Self Report
  • Viral Load

Substances

  • Anti-HIV Agents