The Role of Pharmacy Refill Measures in Assessing Adherence and Predicting HIV Disease Markers in Youth with Perinatally-Acquired HIV (PHIV)
Cenk Yildirim, Patricia A Garvie, Miriam Chernoff, Megan L Wilkins, E Doyle Patton, Paige L Williams, Sharon L Nichols, Memory and Executive Functioning Study of the Pediatric HIV/AIDS Cohort Study, Ram Yogev, Margaret Ann Sanders, Kathleen Malee, Scott Hunter, William Shearer, Mary Paul, Norma Cooper, Lynnette Harris, Murli Purswani, Mahboobullah Baig, Anna Cintron, Ana Navarro, Patricia Garvie, James Blood, Sandra Burchett, Nancy Karthas, Betsy Kammerer, Andrew Wiznia, Marlene Burey, Molly Nozyce, Arry Dieudonne, Linda Bettica, Susan Adubato, Janet Chen, Maria Garcia Bulkley, Latreaca Ivey, Mitzie Grant, Katherine Knapp, Kim Allison, Megan Wilkins, Midnela Acevedo-Flores, Heida Rios, Vivian Olivera, Margarita Silio, Medea Jones, Patricia Sirois, Stephen Spector, Kim Norris, Sharon Nichols, Elizabeth McFarland, Alisa Katai, Jennifer Dunn, Suzanne Paul, Gwendolyn Scott, Patricia Bryan, Elizabeth Willen, Cenk Yildirim, Patricia A Garvie, Miriam Chernoff, Megan L Wilkins, E Doyle Patton, Paige L Williams, Sharon L Nichols, Memory and Executive Functioning Study of the Pediatric HIV/AIDS Cohort Study, Ram Yogev, Margaret Ann Sanders, Kathleen Malee, Scott Hunter, William Shearer, Mary Paul, Norma Cooper, Lynnette Harris, Murli Purswani, Mahboobullah Baig, Anna Cintron, Ana Navarro, Patricia Garvie, James Blood, Sandra Burchett, Nancy Karthas, Betsy Kammerer, Andrew Wiznia, Marlene Burey, Molly Nozyce, Arry Dieudonne, Linda Bettica, Susan Adubato, Janet Chen, Maria Garcia Bulkley, Latreaca Ivey, Mitzie Grant, Katherine Knapp, Kim Allison, Megan Wilkins, Midnela Acevedo-Flores, Heida Rios, Vivian Olivera, Margarita Silio, Medea Jones, Patricia Sirois, Stephen Spector, Kim Norris, Sharon Nichols, Elizabeth McFarland, Alisa Katai, Jennifer Dunn, Suzanne Paul, Gwendolyn Scott, Patricia Bryan, Elizabeth Willen
Abstract
Antiretroviral (ARV) adherence is critical in monitoring disease response in youth with perinatally-acquired HIV (PHIV). We used pharmacy refill (PR) information for PHIV youth from the PHACS Memory Sub-study to calculate medication availability over 2, 4, and 6 months. PR, a proxy of adherence, was compared with self-reported 7-day adherence in predicting suppressed viral load (SVL < 400 copies/mL) and higher CD4% (≥ 25%). Among 159 PHIV youth, 79% were adherent by 7-day recall, and 62, 55, and 48% by PR over 2, 4, and 6 months, respectively. Agreement between 7-day recall and PR adherence was weak (Kappa = 0.09-0.25). In adjusted logistic regression models, adherence showed associations with SVL for 7-day recall (OR 2.78, 95% CI 1.08, 7.15) and all PR coverage periods (6-month: OR 3.24, 95% CI 1.22, 8.65). Similar associations were observed with higher CD4%. PR measures were predictive of study retention. Findings suggest a possibly independent role of PR adherence measures.
Keywords: ARV adherence; Appointment adherence; Pediatric HIV; Pharmacy refill; Self-report.
Conflict of interest statement
Conflict of Interest All authors, Cenk Yildirim, Patricia A Garvie, Miriam Chernoff, Megan L Wilkins, E Doyle Patton, Paige L Williams, and Sharon L Nichols declare that they have no conflicts of interest to report.
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Source: PubMed