title: Use of Self-Reported Adherence and Keeping Clinic Appointments as Predictors of Viremia in Routine HIV Care in the Gambia.
abstract: We followed 205 HIV-infected adults on antiretroviral therapy for at least 12 weeks in a Gambian clinic, where routine viral load monitoring was performed. The 1- and 4-week self-reported adherence and timeliness in keeping to scheduled appointments were recorded at each visit. Seventy patients had measurable viremia between the 12th week and the 3rd year of therapy. Survival analysis of the first detectable viral load on therapy demonstrated an association with 4-week (hazard ratio [HR] 2.6, 95% confidence interval [CI] 1.5-4.3, P=.001) and 1-week (HR 1.9, 95% CI 1.1-3.3, P=.024) self-reported suboptimal adherence and with 1 to 15 days of late presentation for appointments (HR 1.6-1.8, P .027-.109). In a multiple regression model, only 4-week self-reported adherence remained as a significant predictor of viremia.
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium kpeterson@itg.be.
authors.forename: Kevin
authors.initials: K
authors.lastname: Peterson
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Joris
authors.initials: J
authors.lastname: Menten
authors.affiliation: Harvard University School of Public Health, Dar es Salaam, Tanzania.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Peterson
authors.affiliation: Medical Research Council, Gambia Unit, Fajara, The Gambia.
authors.forename: Toyin
authors.initials: T
authors.lastname: Togun
authors.affiliation: Medical Research Council, Gambia Unit, Fajara, The Gambia.
authors.forename: Uduak
authors.initials: U
authors.lastname: Okomo
authors.affiliation: Medical Research Council, Gambia Unit, Fajara, The Gambia.
authors.forename: Francis
authors.initials: F
authors.lastname: Oko
authors.affiliation: Medical Research Council, Gambia Unit, Fajara, The Gambia.
authors.forename: Tumani
authors.initials: T
authors.lastname: Corrah
authors.affiliation: Medical Research Council, Gambia Unit, Fajara, The Gambia Cheikh Anta Diop University, West Africa Platform for HIV Intervention Research, Dakar, Senegal.
authors.forename: Assan
authors.initials: A
authors.lastname: Jaye
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
authors.forename: Robert
authors.initials: R
authors.lastname: Colebunders
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001071:Appointments and Schedules; D005260:Female; D005714:Gambia; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology / Q000821:virology*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D057566:Self Report; D019562:Viral Load; D014766:Viremia / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: Gambia; HIV; adherence; antiretroviral treatment; appointment; self-report