title: Adherence to highly active antiretroviral treatment in HIV-infected Rwandan women.
abstract: BACKGROUND
  Scale-up of highly active antiretroviral treatment therapy (HAART) programs in Rwanda has been highly successful but data on adherence is limited. We examined HAART adherence in a large cohort of HIV+ Rwandan women.
  
  
  METHODS
  The Rwanda Women's Interassociation Study Assessment (RWISA) was a prospective cohort study that assessed effectiveness and toxicity of ART. We analyzed patient data 12±3 months after HAART initiation to determine adherence rates in HIV+ women who had initiated HAART.
  
  
  RESULTS
  Of the 710 HIV+ women at baseline, 490 (87.2%) initiated HAART. Of these, 6 (1.2%) died within 12 months, 15 others (3.0%) discontinued the study and 80 others (19.0%) remained in RWISA but did not have a post-HAART initiation visit that fell within the 12±3 month time points leaving 389 subjects for analysis. Of these 389, 15 women stopped their medications without being advised to do so by their doctors. Of the remaining 374 persons who reported current HAART use 354 completed the adherence assessment. All women, 354/354, reported 100% adherence to HAART at the post-HAART visit. The high self-reported level of adherence is supported by changes in laboratory measures that are influenced by HAART. The median (interquartile range) CD4 cell count measured within 6 months prior to HAART initiation was 185 (128, 253) compared to 264 (182, 380) cells/mm(3) at the post-HAART visit. Similarly, the median (interquartile range) MCV within 6 months prior to HAART initiation was 88 (83, 93) fL compared to 104 (98, 110) fL at the 12±3 month visit.
  
  
  CONCLUSIONS
  Self-reported adherence to antiretroviral treatment 12±3 months after initiating therapy was 100% in this cohort of HIV-infected Rwandan women. Future studies should explore country-specific factors that may be contributing to high levels of adherence to HAART in this population.
authors: King Faisal Hospital, Kigali, Rwanda. smusiime9@gmail.com
authors: Stephenson
authors: S
authors: Musiime
authors: Fred
authors: F
authors: Muhairwe
authors: Alfred
authors: A
authors: Rutagengwa
authors: Eugene
authors: E
authors: Mutimura
authors: Kathryn
authors: K
authors: Anastos
authors: Donald R
authors: DR
authors: Hoover
authors: Shi
authors: S
authors: Qiuhu
authors: Elizaphane
authors: E
authors: Munyazesa
authors: Ivan
authors: I
authors: Emile
authors: Annette
authors: A
authors: Uwineza
authors: Ethan
authors: E
authors: Cowan
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1; D006801:Humans; D010349:Patient Compliance; D011446:Prospective Studies; D012432:Rwanda; D014930:Women