title: An update on the Barriers to Adherence and a Definition of Self-Report Non-adherence Given Advancements in Antiretroviral Therapy (ART).
abstract: Relying on the most frequently reported barriers to adherence and convenient definitions of non-adherence may lead to less valid results. We used a dominance analysis (a regression-based approach) to identify the most important barriers to adherence based on effect size using data collected through an online survey. The survey included the Adherence Barrier Questionnaire, self-reported non-adherence defined as a 4-day treatment interruption, and HIV clinical outcomes. The sample (N = 1217) was largely male, gay identified, and White. Nearly 1 in 3 participants reported "simply forgot" as a barrier; however, in a dominance analysis, it yielded a small effect size it its association with a 4-day treatment interruption. Further, dominance analyses stratified by race/ethnicity and age suggested that not all barriers impact all groups equally. The most frequently reported barriers to adherence were not the most important, and interventions should focus on barriers more strongly linked to clinical outcomes.
authors.affiliation: Center for AIDS Prevention Studies, Department of Medicine, University of California - San Francisco, San Francisco, CA, USA. john.sauceda@ucsf.edu.|Center for AIDS Prevention Studies, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, USA. john.sauceda@ucsf.edu.
authors.forename: John A
authors.initials: JA
authors.lastname: Sauceda
authors.affiliation: Center for AIDS Prevention Studies, Department of Medicine, University of California - San Francisco, San Francisco, CA, USA.
authors.forename: Torsten B
authors.initials: TB
authors.lastname: Neilands
authors.affiliation: Center for AIDS Prevention Studies, Department of Medicine, University of California - San Francisco, San Francisco, CA, USA.
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
authors.affiliation: Center for AIDS Prevention Studies, Department of Medicine, University of California - San Francisco, San Francisco, CA, USA.
authors.forename: Parya
authors.initials: P
authors.lastname: Saberi
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D059408:Pain Management; D057566:Self Report; D012944:Social Support; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology
chemical_list: D019380:Anti-HIV Agents
keywords: Adherence; Adherence barriers; Antiretroviral therapy; Dominance analysis; Relative importance