title: Self-Report and Dry Blood Spot Measurement of Antiretroviral Medications as Markers of Adherence in Pregnant Women in Rural South Africa.
abstract: Antiretroviral (ARV) adherence is essential to prevent mother-to-child transmission of HIV. This study compared self-reported adherence versus ARV detection in dried blood spots (DBS) among N = 392 HIV-infected pregnant women in South Africa (SA). Women completed two self-reported adherence measures [visual analog scale (VAS), AIDS Clinical Trials Group Adherence (ACTG)]. Adherence was 89% (VAS), 80% (ACTG), and 74% (DBS). Self-report measures marginally agreed with DBS (VAS: Kappa = 0.101, Area under the ROC curve (AUROC) = 0.543; ACTG: Kappa  = 0.081, AUROC = 0.538). Self-reported adherence was overestimated and agreement with DBS was poor. Validation of self-reported ARV adherence among pregnant HIV+ women in SA is needed.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14 Street, CRB 864 (D-90A), Miami, FL, 33136, USA. malcaide@med.miami.edu.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Alcaide
authors.affiliation: HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa.
authors.forename: Shandir
authors.initials: S
authors.lastname: Ramlagan
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Violeta J
authors.initials: VJ
authors.lastname: Rodriguez
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.|Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Cook
authors.affiliation: HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa.|ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand.|Department of Research & Innovation, University of Limpopo, Sovenga, South Africa.
authors.forename: Karl
authors.initials: K
authors.lastname: Peltzer
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Weiss
authors.affiliation: HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa.
authors.forename: Sibusiso
authors.initials: S
authors.lastname: Sifunda
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Jones
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000097:blood* / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D055118:Medication Adherence; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D012424:Rural Population; D057566:Self Report; D013019:South Africa; D064232:Visual Analog Scale; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: Adherence; Antiretrovirals; HIV; Measurement; South Africa; Women