title: Self-Report Measures in the Assessment of Antiretroviral Medication Adherence: Comparison with Medication Possession Ratio and HIV Viral Load.
abstract: BACKGROUND
  Adherence is a major determinant of the effectiveness of antiretroviral therapy (ART). We determined the association between self-reported adherence (SRA) and medication possession ratio (MPR), a pharmacy-based adherence measure, and their respective associations with viral load.
  
  
  METHODS
  Adherence to ART was assessed by MPR over 6 months and by self-report which included a question with a Likert-type scale response, a visual analogue scale (VAS), and an inquiry about the last time the patients skipped any prescribed medications.
  
  
  RESULTS
  Taking MPR as the "gold standard," all 3 SRA measures displayed high specificity but low sensitivity. The prevalence ratio (95% confidence interval) for viral load ≥50 copies/mL was 2.19 (1.07-4.50) for MPR <90%, 1.98 (1.04-3.78) for poor/fair/good versus excellent/very good ability to take antiretroviral drugs, 1.47 (0.79-2.75) for skipping medications within the past 2 weeks, and 2.51 (1.39-4.53) for VAS <95%.
  
  
  CONCLUSIONS
  These data suggest various SRA measures hold clinical value in screening for poor ART adherence.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.
authors.forename: Lassane
authors.initials: L
authors.lastname: Kabore
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Chamot
authors.affiliation: Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Zinski
authors.affiliation: Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
authors.forename: Greer
authors.initials: G
authors.lastname: Burkholder
authors.affiliation: Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA mmugavero@uab.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D057566:Self Report; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; adherence; antiretroviral therapy; medication possession ratio