title: Antiretroviral adherence and use of alternative therapies among older HIV-infected adults.
abstract: OBJECTIVE
  To investigate adherence to antiretroviral therapy and use of alternative therapies among older human immunodeficiency virus (HIV)-infected adults, and to assess relationships between antiretroviral adherence and clinical outcomes.
  
  
  METHODS
  One hundred older HIV-infected patients, aged 50 and over, treated at two large HIV clinics in Washington, DC, were enrolled. A cross-sectional methodology used structured interviews to investigate antiretroviral regimens, use of alternative therapies, and demographics. Medical records provided viral load and CD4 count within 3 months of interview.
  
  
  RESULTS
  The mean self-reported adherence was 94%, and 55 patients reported 100% adherence to antiretroviral therapy. Correlation analysis showed a significant negative correlation between adherence and viral load (r = -312, p = 0.005). There was no significant difference in adherence based on race, gender, mode of transmission, or education. Twenty-one patients (21%) reported the use of an alternative therapy, with several patients using multiple alternative therapies. There was no significant difference in adherence score (p = 0.514) or viral load (p = 0.860) based upon use of alternative therapies.
  
  
  CONCLUSIONS
  Older HIV-infected study patients reported high levels of adherence to antiretroviral regimens, and adherence was highly correlated with HIV viral load. Use of alternative therapies did not significantly impact adherence to antiretroviral agents or viral load. High adherence among this older population may be related to older patients' familiarity with medication usage, their increasing awareness of HIV as a disease that requires optimal adherence, and educational efforts promoted by the two clinics in which they are clients.
authors.affiliation: Howard University, School of Pharmacy, Washington, DC 20059, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Wutoh
authors.forename: C M
authors.initials: CM
authors.lastname: Brown
authors.forename: E K
authors.initials: EK
authors.lastname: Kumoji
authors.forename: M S
authors.initials: MS
authors.lastname: Daftary
authors.forename: T
authors.initials: T
authors.lastname: Jones
authors.forename: N A
authors.initials: NA
authors.lastname: Barnes
authors.forename: N J
authors.initials: NJ
authors.lastname: Powell
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004219:District of Columbia; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents