Adherence to highly active antiretroviral therapy assessed by pharmacy claims predicts survival in HIV-infected South African adults

Jean B. Nachega, Michael Hislop, David Wesley Dowdy, Melanie Lo, Saad B. Omer, Leon Regensberg, Richard E Chaisson, Gary Maartens

Research output: Contribution to journalArticle

Abstract

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 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.

Original languageEnglish (US)
Pages (from-to)78-84
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume43
Issue number1
DOIs
StatePublished - Sep 2006

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Highly Active Antiretroviral Therapy
HIV
Survival
Private Sector
Africa South of the Sahara
Proportional Hazards Models
HIV-1
Acquired Immunodeficiency Syndrome
Mortality
Population

Keywords

  • Adherence
  • HAART
  • HIV
  • Pharmacy claims
  • South Africa
  • Survival

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Adherence to highly active antiretroviral therapy assessed by pharmacy claims predicts survival in HIV-infected South African adults. / Nachega, Jean B.; Hislop, Michael; Dowdy, David Wesley; Lo, Melanie; Omer, Saad B.; Regensberg, Leon; Chaisson, Richard E; Maartens, Gary.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 43, No. 1, 09.2006, p. 78-84.

Research output: Contribution to journalArticle

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