title: Antiretroviral therapy in Zambia: do partners on ART enhance adherence?
abstract: BACKGROUND
  Adherence to antiretroviral therapy (ART) is essential to optimize HIV treatment outcomes. Among individuals on ART, targeted peer support has been found to support adherence. This study of Zambian heterosexual couples living with HIV examined whether partners would exert a positive influence on each other's adherence, and compared adherence between couples in which either one or both members were on ART.
  
  
  METHODS
  Couples (n = 446 participants), in which either or both member were on ART were assessed at baseline, 6 and 12 months.
  
  
  RESULTS
  Most participants (64%, n = 263) were on ART; overall, uptake of ART increased to 74% at 12 months. At baseline, 76% reported near perfect adherence; at 6 and 12 months, 66% and 70% were adherent, respectively. A regression analysis indicated that the decline in adherence did not differ between those couples in which one or both partners were on ART [F (2, 624) = 0.37, p = .692]. Pairwise comparison indicated that adherence primarily decreased between baseline and 6 months (t = 2.72, p = .007), and was stable 6 to 12 months.
  
  
  CONCLUSIONS
  This study of couples in Zambia found adherence was not enhanced by having a partner on ART, and that adherence declined over time. Partners on ART may not necessarily provide support for adherence to each other. Partners may represent an untapped resource for optimizing adherence; results highlight the need for provider guidance and structured adherence interventions targeting partner adherence support.
authors.affiliation: University of Miami Miller School of Medicine, Department of Psychiatry & Behavioral, Miami, FL, USA djones@med.miami.edu.
authors.forename: Deborah
authors.initials: D
authors.lastname: Jones
authors.affiliation: University of Miami Miller School of Medicine, Department of Psychiatry & Behavioral, Miami, FL, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Cook
authors.affiliation: University of Miami Miller School of Medicine, Department of Psychiatry & Behavioral, Miami, FL, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Spence
authors.affiliation: University of Miami Miller School of Medicine, Department of Psychiatry & Behavioral, Miami, FL, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Weiss
authors.affiliation: University of Zambia School of Medicine, Department of Paediatrics, Lusaka, Zambia.
authors.forename: Ndashi
authors.initials: N
authors.lastname: Chitalu
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology*; D012944:Social Support; D012959:Socioeconomic Factors; D015024:Zambia
chemical_list: D019380:Anti-HIV Agents
keywords: ART; HIV; Zambia; adherence; couples