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      Antiretroviral therapy adherence and viral suppression in HIV-infected drug users: comparison of self-report and electronic monitoring.

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          Abstract

          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 (r>.8 for both measures). Both self-reported and MEMS adherence were correlated with concurrent HIV load (r=.43-.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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          Author and article information

          Journal
          Clin Infect Dis
          Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
          University of Chicago Press
          1058-4838
          1058-4838
          Oct 15 2001
          : 33
          : 8
          Affiliations
          [1 ] AIDS Research Program, Department of Epidemiology and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York 10467, USA. jarnsten@montefiore.org
          Article
          CID001758 NIHMS10937
          10.1086/323201
          2692641
          11550118
          18338c9e-c679-4611-afa0-22643ddfd38e
          History

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