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Self-Report Measures of Antiretroviral Therapy Adherence: A Review with Recommendations for HIV Research and Clinical Management

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Abstract

A review of 77 studies employing self-report measures of antiretroviral adherence published 1/1996 through 8/2004 revealed great variety in adherence assessment item content, format, and response options. Recall periods ranged from 2 to 365 days (mode=7 days). The most common cutoff for optimal adherence was 100% (21/48 studies, or 44%). In 27 of 34 recall periods (79%), self-reported adherence was associated with adherence as assessed with other indirect measures. Data from 57 of 67 recall periods (84%) indicated self-reported adherence was significantly associated with HIV-1 RNA viral load; in 16 of 26 (62%), it was associated with CD4 count. Clearly, the field would benefit from item standardization and a priori definitions and operationalizations of adherence. We conclude that even brief self-report measures of antiretroviral adherence can be robust, and recommend items and strategies for HIV research and clinical management.

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Acknowledgments

We are grateful to researchers who shared their materials with us and provided feedback regarding this review, especially Pythia Nieuwkerk and Glenn Wagner. This work was supported by University of Washington Center for AIDS Research Sociobehavioral and Prevention Research Core (P30 AI 27757) funding to Dr. Kurth, 2 R01 MH58986 to Dr. Simoni, and F31 MH71179 to Mr. Pantalone.

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Authors and Affiliations

  1. Department of Psychology, University of Washington, Seattle, Washington, 98195-1525, Box 351525, USA

    Jane M. Simoni & David W. Pantalone

  2. School of Nursing/CFAR, University of Washington, Seattle, Washington, USA

    Ann E. Kurth

  3. School of Public Health & Community Medicine, University of Washington, Seattle, Washington, USA

    Cynthia R. Pearson

  4. Department of Medicine, University of Washington, Seattle, Washington, USA

    Joseph O. Merrill

  5. Department of Pharmacy, University of Washington, Seattle, Washington, USA

    Pamela A. Frick

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  1. Jane M. Simoni
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  2. Ann E. Kurth
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  3. Cynthia R. Pearson
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  6. Pamela A. Frick
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Correspondence to Jane M. Simoni.

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Simoni, J.M., Kurth, A.E., Pearson, C.R. et al. Self-Report Measures of Antiretroviral Therapy Adherence: A Review with Recommendations for HIV Research and Clinical Management. AIDS Behav 10, 227–245 (2006). https://doi.org/10.1007/s10461-006-9078-6

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