title: Behavioral correlates of adherence to antiretroviral therapy.
abstract: The objective of this study was to analyze the relationships between adherence to treatment and sexual and drug-taking behaviors among persons with HIV, who started combination antiretroviral therapy as their first regimen. The authors analyzed data from 366 patients enrolled in a multicenter observational cohort study conducted in infectious disease hospital units in Italy. Adherence measurement was based on responses to a self-administered questionnaire regarding following HIV physician advice on taking medications and missed appointments. Questions on sexual and drug-taking behaviors were also included in the questionnaire. The median time since starting antiretroviral therapy was 11.8 months; 37.4% of patients were on a two-drug regimen and 62.6% were on a three-drug regimen. Overall, 68 patients (18.6%) could be classified as nonadherent. The proportion of patients with viral load < or = 500 copies/mL was significantly higher among adherent patients (68%) compared with nonadherent patients (40.4%; p = .001). In multivariable analysis, age (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.42-0.98, per 10-year increment) and current use of injection (OR, 3.47; 95% CI, 1.40-8.5) or noninjection drugs (OR, 4.23; 95% Cl, 1.85-9.67) were significantly associated with nonadherence. No significant association was found between adherence and sexual behaviors. The data do not support the hypothesis that among HIV-infected person on antiretroviral therapy, poor adherence is associated with high-risk sexual behaviors that may further spread the infection.
authors.affiliation: Dipartimento di Epidemiologia, Istituto Nazionale per le Malattie Infettive L. Spallanzani-IRCCS, Rome, Italy.
authors.forename: Maria Stella
authors.initials: MS
authors.lastname: Aloisi
authors.forename: Claudio
authors.initials: C
authors.lastname: Arici
authors.forename: Roberta
authors.initials: R
authors.lastname: Balzano
authors.forename: Pasquale
authors.initials: P
authors.lastname: Noto
authors.forename: Rita
authors.initials: R
authors.lastname: Piscopo
authors.forename: Gaetano
authors.initials: G
authors.lastname: Filice
authors.forename: Francesco
authors.initials: F
authors.lastname: Menichetti
authors.forename: Antonella
authors.initials: A
authors.lastname: d'Arminio Monforte
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ippolito
authors.forename: Enrico
authors.initials: E
authors.lastname: Girardi
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D019380:Anti-HIV Agents