A Self-Reported Adherence Measure to Screen for Elevated HIV Viral Load in Pregnant and Postpartum Women on Antiretroviral Therapy

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• 作者：Tamsin Phillips ; Kirsty Brittain ; Claude A. Mellins ; Allison Zerbe…
• 关键词：Maternal antiretroviral therapy ; Adherence ; Self ; report ; Psychometric scale ; Viral load ; South Africa
• 刊名：AIDS and Behavior
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：21
• 期：2
• 页码：450-461
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Public Health; Health Psychology; Infectious Diseases;
• 出版者：Springer US
• ISSN：1573-3254
• 卷排序：21

文摘

Maternal adherence to antiretroviral therapy (ART) is a concern and monitoring adherence presents a significant challenge in low-resource settings. We investigated the association between self-reported adherence, measured using a simple three-item scale, and elevated viral load (VL) among HIV-infected pregnant and postpartum women on ART in Cape Town, South Africa. This is the first reported use of this scale in a non-English speaking setting and it achieved good psychometric characteristics (Cronbach α = 0.79). Among 452 women included in the analysis, only 12 % reported perfect adherence on the self-report scale, while 92 % had a VL <1000 copies/mL. Having a raised VL was consistently associated with lower median adherence scores and the area under the curve for the scale was 0.599, 0.656 and 0.642 using a VL cut-off of ≥50, ≥1000 and ≥10000 copies/mL, respectively. This simple self-report adherence scale shows potential as a first-stage adherence screener in this setting. Maternal adherence monitoring in low resource settings requires attention in the era of universal ART, and the value of this simple adherence scale in routine ART care settings warrants further investigation.