Nur Afiqah Mohd Salleh1, Lindsey Richardson, Thomas Kerr, Jean Shoveller, Julio Montaner, Adeeba Kamarulzaman, M-J Milloy. 1. British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada (NAMS, LR, TK, JS, JM, M-JM); Interdisciplinary Studies Graduate Program, University of British Columbia (UBC), Vancouver, Canada (NAMS); Department of Sociology, UBC, Vancouver, Canada (LR); Department of Medicine, UBC, Vancouver, Canada (TK, JM, M-JM); School of Population and Public Health, (UBC), Canada (JS); Department of Medicine, University of Malaya, Malaysia (AK).
Abstract
OBJECTIVES: Among people living with HIV (PLWH), high levels of adherence to prescribed antiretroviral therapy (ART) is required to achieve optimal treatment outcomes. However, little is known about the effects of daily pill burden on adherence amongst PLWH who use drugs. We sought to investigate the association between daily pill burden and adherence to ART among members of this key population in Vancouver, Canada. METHODS: We used data from the AIDS Care Cohort to Evaluate Exposure to Survival Services study, a long-running community-recruited cohort of PLWH who use illicit drugs linked to comprehensive HIV clinical records. The longitudinal relationship between daily pill burden and the odds of ≥95% adherence to ART among ART-exposed individuals was analyzed using multivariable generalized linear mixed-effects modeling, adjusting for sociodemographic, behavioural, and structural factors linked to adherence. RESULTS: Between December 2005 and May 2014, the study enrolled 770 ART-exposed participants, including 257 (34%) women, with a median age of 43 years. At baseline, 437 (56.7%) participants achieved ≥95% adherence in the previous 180 days. Among all interview periods, the median adherence was 100% (interquartile range 71%-100%). In a multivariable model, a greater number of pills per day was negatively associated with ≥95% adherence (adjusted odds ratio [AOR] 0.87 per pill, 95% confidence interval [CI] 0.84-0.91). Further analysis showed that once-a-day ART regimens were positively associated with optimal adherence (AOR 1.39, 95% CI 1.07-1.80). CONCLUSIONS: In conclusion, simpler dosing demands (ie, fewer pills and once-a-day single tablet regimens) promoted optimal adherence among PLWH who use drugs. Our findings highlight the need for simpler dosing to be encouraged explicitly for PWUD with multiple adherence barriers.
OBJECTIVES: Among people living with HIV (PLWH), high levels of adherence to prescribed antiretroviral therapy (ART) is required to achieve optimal treatment outcomes. However, little is known about the effects of daily pill burden on adherence amongst PLWH who use drugs. We sought to investigate the association between daily pill burden and adherence to ART among members of this key population in Vancouver, Canada. METHODS: We used data from the AIDS Care Cohort to Evaluate Exposure to Survival Services study, a long-running community-recruited cohort of PLWH who use illicit drugs linked to comprehensive HIV clinical records. The longitudinal relationship between daily pill burden and the odds of ≥95% adherence to ART among ART-exposed individuals was analyzed using multivariable generalized linear mixed-effects modeling, adjusting for sociodemographic, behavioural, and structural factors linked to adherence. RESULTS: Between December 2005 and May 2014, the study enrolled 770 ART-exposed participants, including 257 (34%) women, with a median age of 43 years. At baseline, 437 (56.7%) participants achieved ≥95% adherence in the previous 180 days. Among all interview periods, the median adherence was 100% (interquartile range 71%-100%). In a multivariable model, a greater number of pills per day was negatively associated with ≥95% adherence (adjusted odds ratio [AOR] 0.87 per pill, 95% confidence interval [CI] 0.84-0.91). Further analysis showed that once-a-day ART regimens were positively associated with optimal adherence (AOR 1.39, 95% CI 1.07-1.80). CONCLUSIONS: In conclusion, simpler dosing demands (ie, fewer pills and once-a-day single tablet regimens) promoted optimal adherence among PLWH who use drugs. Our findings highlight the need for simpler dosing to be encouraged explicitly for PWUD with multiple adherence barriers.
Authors: M J Milloy; Thomas Kerr; Jane Buxton; Tim Rhodes; Silvia Guillemi; Robert Hogg; Julio Montaner; Evan Wood Journal: J Infect Dis Date: 2011-05-01 Impact factor: 5.226
Authors: Evan Wood; Julio S G Montaner; Keith Chan; Mark W Tyndall; Martin T Schechter; David Bangsberg; Michael V O'Shaughnessy; Robert S Hogg Journal: AIDS Date: 2002-10-18 Impact factor: 4.177
Authors: V E Stone; J W Hogan; P Schuman; A M Rompalo; A A Howard; C Korkontzelou; D K Smith Journal: J Acquir Immune Defic Syndr Date: 2001-10-01 Impact factor: 3.731
Authors: Evan Wood; Julio S G Montaner; Benita Yip; Mark W Tyndall; Martin T Schechter; Michael V O'Shaughnessy; Robert S Hogg Journal: Antivir Ther Date: 2004-04
Authors: William K Lee; Michael John S Milloy; Ekaterina Nosova; John Walsh; Thomas Kerr Journal: J Acquir Immune Defic Syndr Date: 2019-01-01 Impact factor: 3.731
Authors: Asante R Kamkwalala; Kunbo Wang; Yanxun Xu; Leah H Rubin; Jane O'Halloran; Dionna W Williams; Raha Dastgheyb; Kathryn C Fitzgerald; Amanda B Spence; Pauline M Maki; Deborah R Gustafson; Joel Milam; Anjali Sharma; Kathleen M Weber; Adaora A Adimora; Igho Ofotokun; Anandi N Sheth; Cecile D Lahiri; Margaret A Fischl; Deborah Konkle-Parker Journal: AIDS Behav Date: 2021-01
Authors: Vanessa Castro-Granell; María José Fuster-RuizdeApodaca; Noé Garin; Ángeles Jaén; José Luis Casado; Lorna Leal; Santiago Cenoz Journal: AIDS Behav Date: 2021-05-01