Relationship between viral load and self-report measures of medication adherence among youth with perinatal HIV infection

Ann Usitalo*, Erin Leister, Katherine Tassiopoulos, Susannah Allison, Kathleen Malee, Mary E. Paul, Renee Smith, Russell B. Van Dyke, George R. Seage, Claude A. Mellins

*Corresponding author for this work

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

Poor adherence to antiretroviral therapy (ART) contributes to disease progression and emergence of drug-resistant HIV in youth with perinatally acquired HIV infection (PHIV +), necessitating reliable measures of adherence. Although electronic monitoring devices have often been considered the gold-standard assessment in HIV research, they are costly, can overestimate nonadherence and are not practical for routine care. Thus, the development of valid, easily administered self-report adherence measures is crucial for adherence monitoring. PHIV+youth aged 7-16 (n = 289) and their caregivers, enrolled in a multisite cohort study, were interviewed to assess several reported indicators of adherence. HIV-1 RNA viral load (VL) was dichotomized into >/≤400 copies/mL. Lower adherence was significantly associated with VL >400 copies/mL across most indicators, including ≥1 missed dose in past seven days [youth report: OR = 2.78 (95% CI, 1.46-5.27)]. Caregiver and combined youth/caregiver reports yielded similar results. Within-rater agreement between various adherence indicators was high for both youth and caregivers. Inter-rater agreement on adherence was moderate across most indicators. Age ≥13 years and living with biological mother or relative were associated with VL >400 copies/mL. Findings support the validity of caregiver and youth adherence reports and identify youth at risk of poor adherence.

Original languageEnglish (US)
Pages (from-to)107-115
Number of pages9
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume26
Issue number1
DOIs
StatePublished - Jan 2 2014

Keywords

  • HIV
  • adherence
  • antiretroviral
  • pediatric

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Public Health, Environmental and Occupational Health

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