Background: Antiretroviral adherence is essential to HIV treatment efcacy. Various self-reported measures are commonly used for assessing antiretroviral adherence. Limited data are available regarding the validity of those selfreported measures in comparison with long-term objective biomarkers of adherence measures such as hair measures.
Methods: Self-reported adherence (frequency, percentage, and visual analog scale [VAS]) and hair tenofovir concentration were evaluated at a single time point from 268 people living with HIV in China. The responses to each of three self-reported measures were converted into percentage and then dichotomized as “optimal” (100%) vs. “suboptimal” (less than 100%) adherence. Two composite adherence scores (CAS) were created from the three self-reported measures: (1) an overall adherence was the average percentage of the three self-reported measures; (2) responses were termed optimal adherence if participants reporting optimal adherence in all three self-reported measures, while were termed suboptimal adherence. Hair tenofovir concentration was also dichotomized as “optimal” (above the limit of quantitation, 36 pg/mg) vs. “suboptimal” adherence (blow 36 pg/mg). Spearman correlation, kappa statistics, and logistic regression analysis were used to calculate the correlations, agreements, and predictions of self-reported measures with hair measure, respectively.
Results: Overall adherence, but any of the three self-reported adherence, was correlated with hair tenofovir concentration (r=0.13, p<0.05). Self-reported optimal adherence in VAS and CAS measures were agreed with and predicted optimal adherence assessed by hair measure (Kappa=0.107, adjusted OR=1.88, 95% CI 1.03–3.45; Kappa=0.109, adjusted OR=1.80, 95% CI 1.02–3.18; all p<0.05, respectively).
Conclusion: VAS may be a good individual self-reported measure for antiretroviral adherence, and CAS may be a good composite self-reported measure for antiretroviral adherence
Digital Object Identifier (DOI)
Published in AIDS Research and Therapy, Volume 17, Issue 8, 2020.
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Zhang, Q., Li, X., Qiao, S., Shen, Z., & Zhou, Y. (2020). Comparing self-reported medication adherence measures with hair antiretroviral concentration among people living with HIV in Guangxi, China. AIDS Research And Therapy, 17(8). https://doi.org/10.1186/s12981-020-00265-4