title: Assessing antiretroviral adherence via electronic drug monitoring and self-report: an examination of key methodological issues.
abstract: We explored methodological issues related to antiretroviral adherence assessment, using 6 months of data collected in a completed intervention trial involving 136 low-income HIV-positive outpatients in the Bronx, NY. Findings suggest that operationalizing adherence as a continuous (versus dichotomous) variable and averaging adherence estimates over multiple assessment points (versus using only one) explains greater variance in HIV-1 RNA viral load (VL). Self-reported estimates provided during a phone interview accounted for similar variance in VL as EDM estimates (R (2) = .17 phone versus .18 EDM). Self-reported adherence was not associated with a standard social desirability measure, and no difference in the accuracy of self-report adherence was observed for assessment periods of 1-3 days. Self-reported poor adherence was more closely associated with EDM adherence estimates than self-reported moderate and high adherence. On average across assessment points, fewer than 4% of participants who reported taking a dose of an incorrect amount of medication.
authors.affiliation: Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98105-1525, USA. pearsonc@u.washington.edu
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Pearson
authors.forename: Jane M
authors.initials: JM
authors.lastname: Simoni
authors.forename: Peter
authors.initials: P
authors.lastname: Hoff
authors.forename: Ann E
authors.initials: AE
authors.lastname: Kurth
authors.forename: Diane P
authors.initials: DP
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D016903:Drug Monitoring / Q000295:instrumentation / Q000379:methods*; D004581:Electronics / Q000295:instrumentation; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D012367:RNA, Viral / Q000097:blood; D012650:Self Disclosure; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral