title: Factors and temporal trends associated with highly active antiretroviral therapy discontinuation in the Women's Interagency HIV Study.
abstract: We characterized factors and temporal trends associated with discontinuation of highly active antiretroviral therapy (HAART) among 936 HIV-infected women enrolled in the Women's Interagency HIV Study. A multivariate analysis of post-HAART initiation exposures found that high HIV RNA levels (relative hazard [RH] = 1.36, P < 0.001) and high depressive symptom scores (RH = 1.53, P = 0.012) were associated with HAART discontinuation. The adjusted hazard of discontinuation was higher in the 2 most recent calendar periods compared with the first (RH = 1.61, P = 0.026; RH = 1.56, P = 0.074, respectively). The increasing risk of HAART discontinuation in recent calendar periods and changes in the clinical factors associated with discontinuation reflect ongoing and dynamic shifts in the approach to HAART utilization.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. lahdieh@jhmi.edu
authors.forename: Linda
authors.initials: L
authors.lastname: Ahdieh-Grant
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Tarwater
authors.forename: Michael F
authors.initials: MF
authors.lastname: Schneider
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.forename: Mardge
authors.initials: M
authors.lastname: Cohen
authors.forename: Ann
authors.initials: A
authors.lastname: Khalsa
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.forename: Mary
authors.initials: M
authors.lastname: Young
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Greenblatt
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D004358:Drug Therapy / Q000639:trends; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D010349:Patient Compliance; D016016:Proportional Hazards Models; D016312:Treatment Refusal; D016387:Women's Health