title: Self-reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV infection.
abstract: OBJECTIVE
  To identify variables predictive of nonadherence to highly active antiretroviral therapy (HAART) and to assess whether self-reported symptoms or medication side effects are related to adherence.
  
  
  METHODS
  Cross-sectional multicenter study Adherence Italian Cohort Naive Antiretrovirals [AdICONA] within the Italian Cohort Naive Antiretrovirals (ICONA).
  
  
  METHODS
  Participants receiving HAART completed a 16-item self-administered questionnaire to assess nonadherence in the last 3 days as well as the type and intensity of 24 common HIV- and HAART-related symptoms experienced during the last 4 weeks.
  
  
  RESULTS
  From May 1999 to March 2000, 358 persons were enrolled: 22% reported nonadherence and were less likely to have HIV RNA <500 copies/ml (odds ratio = 0.51; 95% confidence interval: 0.31-0.85). Frequency of moderate/severe symptoms or medication side effects in nonadherent participants ranged from 3.6% to 30%. On univariate analysis, nausea, anxiety, confusion, vision problems, anorexia, insomnia, taste perversion, and abnormal fat distribution were significantly associated with nonadherence. Nonadherent persons had a higher mean overall symptom score (12.3 +/- 9.2 versus 8.1 +/- 6.6; p <.001) and mean medication side effect score (2.9 +/- 2.7 versus 1.9 +/- 1.9; p <.001) when compared with adherent participants. In the multivariate analysis, nausea ( p =.003); anxiety ( p =.006); younger age ( p =.007); unemployment ( p <.001); not recalling name, color, and timing of drugs ( p =.009); running out of pills between visits ( p =.002); and being too busy ( p =.03) were independently associated with nonadherence in the last 3 days.
  
  
  CONCLUSIONS
  In addition to patient characteristics, medication-related variables, and reasons for nonadherence, patient-reported symptoms and medication side effects were significantly associated with adherence to HAART.
authors.affiliation: Clinica delle Malattie Infettive, Università Cattolica del S. Cuore, Roma, Italy. aammassari@libero.it
authors.forename: A
authors.initials: A
authors.lastname: Ammassari
authors.forename: R
authors.initials: R
authors.lastname: Murri
authors.forename: P
authors.initials: P
authors.lastname: Pezzotti
authors.forename: M P
authors.initials: MP
authors.lastname: Trotta
authors.forename: L
authors.initials: L
authors.lastname: Ravasio
authors.forename: P
authors.initials: P
authors.lastname: De Longis
authors.forename: S
authors.initials: S
authors.lastname: Lo Caputo
authors.forename: P
authors.initials: P
authors.lastname: Narciso
authors.forename: S
authors.initials: S
authors.lastname: Pauluzzi
authors.forename: G
authors.initials: G
authors.lastname: Carosi
authors.forename: S
authors.initials: S
authors.lastname: Nappa
authors.forename: P
authors.initials: P
authors.lastname: Piano
authors.forename: C M
authors.initials: CM
authors.lastname: Izzo
authors.forename: M
authors.initials: M
authors.lastname: Lichtner
authors.forename: G
authors.initials: G
authors.lastname: Rezza
authors.forename: A
authors.initials: A
authors.lastname: Monforte
authors.forename: G
authors.initials: G
authors.lastname: Ippolito
authors.forename: M
authors.initials: M
authors.lastname: d'Arminio Moroni
authors.forename: A W
authors.initials: AW
authors.lastname: Wu
authors.forename: A
authors.initials: A
authors.lastname: Antinori
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D003221:Confusion / Q000139:chemically induced; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D018451:Homosexuality, Male; D006801:Humans; D007558:Italy; D008297:Male; D015999:Multivariate Analysis; D009325:Nausea / Q000139:chemically induced; D016017:Odds Ratio; D010349:Patient Compliance; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014786:Vision Disorders / Q000139:chemically induced
chemical_list: D019380:Anti-HIV Agents