Evaluating adherence to antiretroviral therapy using pharmacy refill records in a rural treatment site in South Africa

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dc.contributor.authorGachara, George
dc.contributor.authorMavhandu, Lufuno G.
dc.contributor.authorRogawski, Elizabeth T.
dc.contributor.authorManhaeve, Cecile
dc.contributor.authorBessong, Pascal O.
dc.date.accessioned2017-02-10T08:07:46Z
dc.date.available2017-02-10T08:07:46Z
dc.date.issued2017
dc.descriptionResearch articleen_US
dc.description.abstractOptimal 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 suppressionen_US
dc.description.sponsorshipSouth African Medical Research Council and the National Research Foundation of South Africa and the Fogarty International Center of the National Institutes of Health, USAen_US
dc.identifier.citationAIDS Research and Treatment Volume 2017, Article ID 5456219, 6 pages https://doi.org/10.1155/2017/5456219en_US
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/15362
dc.language.isoenen_US
dc.publisherHindawi Publishing Corporationen_US
dc.titleEvaluating adherence to antiretroviral therapy using pharmacy refill records in a rural treatment site in South Africaen_US
dc.typeArticleen_US
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