title: Factors associated with complete adherence to HIV combination antiretroviral therapy.
abstract: OBJECTIVE
  To assess factors associated with adherence, particularly pill burden, to combination antiretroviral therapy (cART) using multivariate models.
  
  
  METHODS
  A cross-sectional survey of US adults with a self-reported diagnosis of HIV/AIDS was conducted between April and May 2007. Respondents on a cART regimen of at least 2 nucleoside reverse transcriptase inhibitors plus at least 1 protease inhibitor or non-nucleoside reverse transcriptase inhibitor (n = 461) were included in the analytic sample. Multiple logistic regression models determined independent predictors of complete adherence (defined as never missing or skipping an antiretroviral dose).
  
  
  RESULTS
  Fifty-four percent of respondents reported complete adherence to cART. Adherent respondents reported a lower percentage of hospitalizations (11% vs 28%; P < .0001) and emergency room visits (26% vs 34%; P < .09). Respondents taking the single tablet efavirenz/emtricitabine/tenofovir fixed-dose regimen were significantly more likely to have complete adherence than respondents taking other cART regimens (odds ratio [OR] 2.1, P < .05), and higher imputed daily HIV pill count was associated with lower likelihood of complete adherence (OR 0.93, P < .05).
  
  
  CONCLUSIONS
  This study shows the negative impact of higher pill burden on medication adherence, an important factor associated with treatment outcomes in patients with HIV/AIDS.
authors.affiliation: Bristol-Myers Squibb, Plainsboro, NJ, USA. timothy.juday@bms.com
authors.forename: Timothy
authors.initials: T
authors.lastname: Juday
authors.forename: Shaloo
authors.initials: S
authors.lastname: Gupta
authors.forename: Kristy
authors.initials: K
authors.lastname: Grimm
authors.forename: Samuel
authors.initials: S
authors.lastname: Wagner
authors.forename: Edward
authors.initials: E
authors.lastname: Kim
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged
chemical_list: D019380:Anti-HIV Agents