Evaluating Adherence to Antiretroviral Therapy Using Pharmacy Refill Records in a Rural Treatment Site in South Africa
Optimal adherence to combination antiretroviral therapy (cART) is critical to maintain virologic suppression, thereby ensuring the global success of HIV treatment. We evaluated adherence to cART using pharmacy refill records and determined the adherence threshold resulting in >90% virologic suppr...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | AIDS Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2017/5456219 |
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| author | George Gachara Lufuno G. Mavhandu Elizabeth T. Rogawski Cecile Manhaeve Pascal O. Bessong |
| author_facet | George Gachara Lufuno G. Mavhandu Elizabeth T. Rogawski Cecile Manhaeve Pascal O. Bessong |
| author_sort | George Gachara |
| collection | DOAJ |
| description | Optimal adherence to combination antiretroviral therapy (cART) is critical to maintain virologic suppression, thereby ensuring the global success of HIV treatment. We evaluated adherence to cART using pharmacy refill records and determined the adherence threshold resulting in >90% virologic suppression in a community run treatment site in South Africa. Additionally, we analysed factors associated with adherence using univariable and multivariable logistic regression models. Logistic regression was also performed to determine the relationship between adherence and virologic suppression and the adherence threshold resulting in <10% virologic failure. The overall median (interquartile range) adherence was 95% (88.6–98.4%). Out of the study participants, 210/401 (52.4%) had optimal (≥95%) adherence while only 37/401 (9.2%) had poor (≤80%) adherence. The majority (90.5%) of patients with optimal adherence had virologic suppression. Having TB at registration into care was found to be negatively associated with adherence (adjusted odds ratio [AOR], 0.382; p≤.05). Compared to nonadherent individuals, optimally adherent participants were more likely to achieve virologic suppression (OR 2.92; 95% CI: 1.63–5.22). Only adherence rates above 95% were observed to lead to <10% virologic failure. cART adherence measured by pharmacy refill records could serve as a useful predictor of virologic failure; adherence rates >95% are needed to maintain optimal virologic suppression. |
| format | Article |
| id | doaj-art-8db3e8afecc24bd0af38a1b2734864d1 |
| institution | Kabale University |
| issn | 2090-1240 2090-1259 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
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| series | AIDS Research and Treatment |
| spelling | doaj-art-8db3e8afecc24bd0af38a1b2734864d12025-02-03T07:24:25ZengWileyAIDS Research and Treatment2090-12402090-12592017-01-01201710.1155/2017/54562195456219Evaluating Adherence to Antiretroviral Therapy Using Pharmacy Refill Records in a Rural Treatment Site in South AfricaGeorge Gachara0Lufuno G. Mavhandu1Elizabeth T. Rogawski2Cecile Manhaeve3Pascal O. Bessong4HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, South AfricaHIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, South AfricaDepartment of Public Health Sciences, University of Virginia, Charlottesville, VA, USAHIV/AIDS Prevention Group Wellness and Health Clinic, Bela Bela, South AfricaHIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, South AfricaOptimal adherence to combination antiretroviral therapy (cART) is critical to maintain virologic suppression, thereby ensuring the global success of HIV treatment. We evaluated adherence to cART using pharmacy refill records and determined the adherence threshold resulting in >90% virologic suppression in a community run treatment site in South Africa. Additionally, we analysed factors associated with adherence using univariable and multivariable logistic regression models. Logistic regression was also performed to determine the relationship between adherence and virologic suppression and the adherence threshold resulting in <10% virologic failure. The overall median (interquartile range) adherence was 95% (88.6–98.4%). Out of the study participants, 210/401 (52.4%) had optimal (≥95%) adherence while only 37/401 (9.2%) had poor (≤80%) adherence. The majority (90.5%) of patients with optimal adherence had virologic suppression. Having TB at registration into care was found to be negatively associated with adherence (adjusted odds ratio [AOR], 0.382; p≤.05). Compared to nonadherent individuals, optimally adherent participants were more likely to achieve virologic suppression (OR 2.92; 95% CI: 1.63–5.22). Only adherence rates above 95% were observed to lead to <10% virologic failure. cART adherence measured by pharmacy refill records could serve as a useful predictor of virologic failure; adherence rates >95% are needed to maintain optimal virologic suppression.http://dx.doi.org/10.1155/2017/5456219 |
| spellingShingle | George Gachara Lufuno G. Mavhandu Elizabeth T. Rogawski Cecile Manhaeve Pascal O. Bessong Evaluating Adherence to Antiretroviral Therapy Using Pharmacy Refill Records in a Rural Treatment Site in South Africa AIDS Research and Treatment |
| title | Evaluating Adherence to Antiretroviral Therapy Using Pharmacy Refill Records in a Rural Treatment Site in South Africa |
| title_full | Evaluating Adherence to Antiretroviral Therapy Using Pharmacy Refill Records in a Rural Treatment Site in South Africa |
| title_fullStr | Evaluating Adherence to Antiretroviral Therapy Using Pharmacy Refill Records in a Rural Treatment Site in South Africa |
| title_full_unstemmed | Evaluating Adherence to Antiretroviral Therapy Using Pharmacy Refill Records in a Rural Treatment Site in South Africa |
| title_short | Evaluating Adherence to Antiretroviral Therapy Using Pharmacy Refill Records in a Rural Treatment Site in South Africa |
| title_sort | evaluating adherence to antiretroviral therapy using pharmacy refill records in a rural treatment site in south africa |
| url | http://dx.doi.org/10.1155/2017/5456219 |
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