title: Correlation between use of antiretroviral adherence devices by HIV-infected youth and plasma HIV RNA and self-reported adherence.
abstract: Our objective was to investigate antiretroviral adherence device use by HIV-infected youth and assess associations of device use with viral suppression and self-reported adherence. This cross-sectional, multisite, clinic-based study included data from 1,317 HIV-infected individuals 12-24 years of age that were prescribed antiretroviral therapy. Mean adherence in the past 7 days was 86.1 % and 50.5 % had an undetectable HIV RNA. Pillbox was the most commonly endorsed device. No specific device was independently associated with higher odds of 100 % adherence. Paradoxically, having an undetectable HIV RNA was inversely associated with use of adherence devices (OR 0.80; p = 0.04); however, among those with <100 % adherence, higher adherence was associated with use of one or more adherence devices (coefficient = 7.32; p = 0.003). Our data suggest that adolescents who experienced virologic failure often used adherence devices which may not have been sufficiently effective in optimizing adherence. Therefore, other tailored adherence-enhancing methods need to be considered to maximize virologic suppression and decrease drug resistance and HIV transmission.
authors.affiliation: Department of Medicine, University of California, UCSF Box 0886, 50 Beale St., Suite 1300, San Francisco, CA, 94105, USA, parya.saberi@ucsf.edu.
authors.forename: Parya
authors.initials: P
authors.lastname: Saberi
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mayer
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naar-King
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D018791:CD4 Lymphocyte Count; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008509:Medication Systems / Q000706:statistics & numerical data*; D017010:Reminder Systems / Q000706:statistics & numerical data*; D012646:Self Administration; D057566:Self Report; D019562:Viral Load; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents