Level of Adherence and HIV RNA Suppression in the Current Era of Highly Active Antiretroviral Therapy (HAART)

The need to achieve a parts per thousand yen95 % adherence to HAART for treatment effectiveness may be a barrier for universal initiation at early stages of HIV. Using longitudinal data collected from 2006 to 2011 from cohort studies of MSM (MACS) and IDUs (ALIVE study), we estimated the minimum adherence needed to achieve HIV RNA suppression (< 50 copies/mL), defined as the level at which at least 80 % were virally suppressed, and the odds of suppression was not significantly different than that observed with a parts per thousand yen95 % adherence. In the MACS, a parts per thousand yen80 % suppression was observed with 80-84 % adherence and the odds ratio for suppression (vs. a parts per thousand yen95 % adherence) was 1.43 (0.61, 3.33). In the ALIVE study where < 35 % were on newer drugs, only 71.4 % were suppressed among those who reported a parts per thousand yen95 % adherence. Although IDUs on older HAART regimens may need to be a parts per thousand yen95 % adherent, concerns related to non-adherence may be less of a barrier to initiation of modern HAART regimens.