Journal
CLINICAL INFECTIOUS DISEASES
Volume 33, Issue 8, Pages 1417-1423Publisher
UNIV CHICAGO PRESS
DOI: 10.1086/323201
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Funding
- NIDA NIH HHS [R01-DA104347, R01-DA11869, R01 DA011869-04] Funding Source: Medline
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To compare electronically monitored (MEMS) with self-reported adherence in drug users, including the impact of adherence on HIV load, we conducted a 6-month observational study of 67 antiretroviral-experienced current and former drug users. Adherence (percentage of doses taken as prescribed) was calculated for both the day and the week preceding each of 6 research visits. Mean self-reported 1-day adherence was 79% (median, 86%), and mean self-reported 1-week adherence was 78% (median, 85%). Mean MEMS 1-day adherence was 57% (median, 52%), and mean MEMS 1-week adherence was 53% (median, 49%). One-day and 1-week estimates were highly correlated ( for both measures). Both self-reported and MEMS adherence were correlated (r>.8 with concurrent HIV load (r = .143-.60), but the likelihood of achieving virologic suppression was greater if MEMS adherence was high than if self-reported adherence was high. We conclude that self-reported adherence is higher than MEMS adherence, but a strong relationship exists between both measures and virus load. However, electronic monitoring is more sensitive than self-report for the detection of nonadherence and should be used in adherence intervention studies.
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