Evaluating adherence to antiretroviral therapy using pharmacy refill records in a rural treatment site in South Africa
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Date
2017
Authors
Gachara, George
Mavhandu, Lufuno G.
Rogawski, Elizabeth T.
Manhaeve, Cecile
Bessong, Pascal O.
Journal Title
Journal ISSN
Volume Title
Publisher
Hindawi Publishing Corporation
Abstract
Optimal adherence to combination antiretroviral therapy (cART) is critical to maintain virologic suppression, thereby ensuring the
global success of HIV treatment. We evaluated adherence to cART using pharmacy refill records and determined the adherence
threshold resulting in >90% virologic suppression in a community run treatment site in South Africa. Additionally, we analysed
factors associated with adherence using univariable and multivariable logistic regression models. Logistic regression was also
performed to determine the relationship between adherence and virologic suppression and the adherence threshold resulting in
<10% virologic failure. The overall median (interquartile range) adherence was 95% (88.6–98.4%). Out of the study participants,
210/401 (52.4%) had optimal (≥95%) adherence while only 37/401 (9.2%) had poor (≤80%) adherence. The majority (90.5%) of
patients with optimal adherence had virologic suppression.Having TB at registration into care was found to be negatively associated
with adherence (adjusted odds ratio [AOR], 0.382; 𝑝 ≤ .05). Compared to nonadherent individuals, optimally adherent participants
were more likely to achieve virologic suppression (OR 2.92; 95% CI: 1.63–5.22). Only adherence rates above 95% were observed to
lead to <10% virologic failure. cART adherence measured by pharmacy refill records could serve as a useful predictor of virologic
failure; adherence rates >95% are needed to maintain optimal virologic suppression
Description
Research article
Keywords
Citation
AIDS Research and Treatment Volume 2017, Article ID 5456219, 6 pages https://doi.org/10.1155/2017/5456219