title: Adherence to highly active antiretroviral therapy predicts virologic outcome at an inner-city human immunodeficiency virus clinic.
abstract: This study's hypothesis is that human immunodeficiency virus-infected patients in the inner city (predominantly injection drug users and ethnic minorities) do not take highly active antiretroviral therapy (HAART) as prescribed and that nonadherence leads to virologic failure. A prospective, observational, 3-month study of adherence to HAART was undertaken at an inner-city clinic. There were 40 subjects [110 subject-months]; 30 were male, 10 were female, 75% were Hispanic, 23% were African American, 68% were injection drug users, and 68% were receiving triple therapy. At 3 months, adherence, which was determined by use of the Medication Event Monitoring System (Aprex) was significantly associated with virologic success: lower virus loads were associated with a rate of adherence of >80% (P<.05). Although nonadherence predicted virologic failure, virologic success was not always predicted by adherence: 11 (27.5%) of 40 subjects with suboptimal adherence rates (<90%) had complete virologic suppression.
authors.affiliation: College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: J
authors.initials: J
authors.lastname: McNabb
authors.forename: J W
authors.initials: JW
authors.lastname: Ross
authors.forename: K
authors.initials: K
authors.lastname: Abriola
authors.forename: C
authors.initials: C
authors.lastname: Turley
authors.forename: C H
authors.initials: CH
authors.lastname: Nightingale
authors.forename: D P
authors.initials: DP
authors.lastname: Nicolau
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods* / Q000706:statistics & numerical data; D018791:CD4 Lymphocyte Count; D003237:Connecticut; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014505:Urban Population / Q000706:statistics & numerical data*; D019562:Viral Load