Measuring Antiretroviral Adherence Among Young People Living with HIV: Observations from a Real-Time Monitoring Device Versus Self-report

AIDS Behav. 2019 Aug;23(8):2138-2145. doi: 10.1007/s10461-019-02448-1.

Abstract

This report compares self-report (SR) antiretroviral (ARV) adherence data to adherence data collected via Wisepill, a real-time electronic monitoring (EM) device, among young people living with HIV (YPLH) in the southern United States. Participants (n = 66; ages 16 to 26) were followed for 14 weeks. Descriptive analyses were used to compare SR to EM data. Correlations and a linear regression were conducted to explore factors possibly associated with SR-EM discrepancies. We also examined associations between various levels of SR and EM adherence and viral suppression/non-suppression at 14 weeks. Rates of SR adherence were maintained between 87% and 92% while rates of EM adherence declined from 64% to 34%. YPLH who were ARV-experienced, had lower treatment motivation, and reported more frequent recent marijuana use, had a greater discrepancy between their SR and EM adherence levels compared to other YPLH. Higher rates of SR and EM adherence were independently associated with a decline in viral load. A sensitivity analysis also revealed that SR adherence was a better predictor of viral non-suppression, whereas EM adherence was a better predictor of viral suppression. These measurement approaches are discussed in the context of providing clinical care to YPLH.

Keywords: Adherence; Antiretroviral; HIV; Measurement; Youth.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active*
  • Female
  • HIV
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data*
  • Self Disclosure
  • Self Report
  • Viral Load / drug effects*
  • Young Adult

Substances

  • Anti-Retroviral Agents