Evaluation of adherence and factors affecting adherence to combination antiretroviral therapy among white, hispanic, and black men in the MACS cohort

OBJECTIVES: This study investigated levels of adherence to antiretroviral therapy in white, Hispanic, and black men and isolated factors associated with adherence among each racial group. METHODS: Data were collected from 1102 men enrolled in the Multicenter AIDS Cohort Study followed between April 2002 and October 2006. Self-reported 100% adherence was defined as taking all doses and pills over the previous 4-day period, reporting not typically skipping any medications, and reporting always following the medication schedule. Variables associated with adherence were determined by multilevel logistic regression for each racial group. Adherence was also analyzed by ethnicity within racial groups. RESULTS: After controlling for confounders, we found that Hispanics were 2.16 times and blacks were 1.37 times more likely than whites to not report 100% adherence (95% confidence interval 1.47 to 3.18 and 1.05 to 1.79, respectively). Hispanics with ethnic backgrounds from Central and South America and the Caribbean had lower rates of adherence. Blacks with ethnic backgrounds from the Caribbean had lower rates of adherence than those from other regions.