Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Adherence to highly active antiretroviral therapy assessed by pharmacy claims predicts survival in HIV-infected South African adults
Journal of Acquired Immune Deficiency Syndromes, Volume 43, No. 1, Year 2006
Notification
URL copied to clipboard!
Description
It is unclear how adherence to highly active antiretroviral therapy (HAART) may best be monitored in large HIV programs in sub-Saharan Africa where it is being scaled up. We aimed to evaluate the association between HAART adherence, as estimated by pharmacy claims, and survival in HIV-1-infected South African adults enrolled in a private-sector AIDS management program. Of the 6288 patients who began HAART between January 1999 and August 2004, 3805 (61%) were female and 6094 (97%) were black African. HAART adherence was ≥80% for 3298 patients (52%) and 100% for 1916 patients (30%). Women were significantly more likely to have adherence ≥80% than men (54% vs 49%, P < 0.001). The median (interquartile range) follow-up time was 1.8 (1.37-2.5) years. As of 1 September 2004, 222 patients had died-a crude mortality rate of 3.5%. In a multivariate Cox regression model, adherence <80% was associated with lower survival (relative hazard 3.23; 95% confidence interval: 2.37-4.39). When medication adherence was divided into 5 strata with a width of 20% each, each stratum had lower survival rates than the adjacent, higher-adherence stratum. Among other variables tested, only baseline CD4 T-cell count was significantly associated with decreased survival in multivariate analysis (relative hazard 5.13; 95% confidence interval: 3.42-7.72, for CD4 T-cell count ≤50 cells/μL vs >200 cells/μL). Pharmacy-based records may be a simple and effective population-level tool for monitoring adherence as HAART programs in Africa are scaled up. Copyright © 2006 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Nachega, J. B.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Hislop, Michael S.
South Africa, Cape Town
Aid for Aids Disease Management Programme Pty Ltd.
Dowdy, David W.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Lo, Melanie W.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Omer, Saad B.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Regensberg, Leon D.
South Africa, Cape Town
Aid for Aids Disease Management Programme Pty Ltd.
Chaisson, Richard E.
United States, Baltimore
Johns Hopkins University
Maartens, Gary Tuberculosis
South Africa, Cape Town
University of Cape Town
Statistics
Citations: 302
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1097/01.qai.0000225015.43266.46
ISSN:
15254135
Research Areas
Environmental
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Participants Gender
Male
Female