Association of first-line and second-line antiretroviral therapy adherence.

Published online

Journal Article

BACKGROUND: Adherence to first-line antiretroviral therapy (ART) may be an important indicator of adherence to second-line ART. Evaluating this relationship may be critical to identify patients at high risk for second-line failure, thereby exhausting their treatment options, and to intervene and improve patient outcomes. METHODS: Adolescents and adults (n = 436) receiving second-line ART were administered standardized questionnaires that captured demographic characteristics and assessed adherence. Optimal and suboptimal cumulative adherence were defined as percentage adherence of ≥90% and <90%, respectively. Bivariable and multivariable binomial regression models were used to assess the prevalence of suboptimal adherence percentage by preswitch adherence status. RESULTS: A total of 134 of 436 (30.7%) participants reported suboptimal adherence to second-line ART. Among 322 participants who had suboptimal adherence to first-line ART, 117 (36.3%) had suboptimal adherence to second-line ART compared with 17 of 114 (14.9%) who had optimal adherence to first-line ART. Participants who had suboptimal adherence to first-line ART were more likely to have suboptimal adherence to second-line ART (adjusted prevalence ratio, 2.4; 95% confidence interval, 1.5-3.9). CONCLUSIONS: Adherence to first-line ART is an important predictor of adherence to second-line ART. Targeted interventions should be evaluated in patients with suboptimal adherence before switching into second-line therapy to improve their outcomes.

Full Text

Duke Authors

Cited Authors

  • Ramadhani, HO; Bartlett, JA; Thielman, NM; Pence, BW; Kimani, SM; Maro, VP; Mwako, MS; Masaki, LJ; Mmbando, CE; Minja, MG; Lirhunde, ES; Miller, WC

Published Date

  • September 2014

Published In

Volume / Issue

  • 1 / 2

Start / End Page

  • ofu079 -

PubMed ID

  • 25734147

Pubmed Central ID

  • 25734147

International Standard Serial Number (ISSN)

  • 2328-8957

Digital Object Identifier (DOI)

  • 10.1093/ofid/ofu079


  • eng

Conference Location

  • United States