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Medication Adherence Among HIV-Positive Women
Monthly Summaries of Nursing Research
Durante
AJ, Bova CA, Fennie KP, et al. Home-based study of
anti-HIV drug regimen adherence among HIV-infected
women: feasibility and preliminary results. AIDS
Care. 2003;15:103-115.
For
HIV-positive patients, effective therapy often requires
complex dosing regimens involving combinations of
antiretroviral medications to suppress viral
replication, delay disease progression, and prolong
survival. However, poor compliance with this medication
regimen can lead to incomplete viral suppression and the
development of drug-resistant strains. Researchers
conducted in-home interviews with 63 HIV-positive women
to assess medication compliance. Almost half of the
women in the sample were 40-49 years of age; 62% were
African American, 29% were white, and 5% were Latina;
70% were high school graduates; and most reported a
history of drug and alcohol use. Most had visited their
HIV clinic within the last 3 months, but 30% did not
know their most recent CD4 T-cell count, and 34% did not
know their most recent viral load result. For their HIV
treatment, 77% were on a highly active antiretroviral
therapy (HAART) regimen involving 3 or more medications.
By recall over the previous 3 days, 67% reported taking
all of their prescribed medications, while 11% took less
than half. Reasons given by women who missed doses
included forgetting about the dose; being away from
home, busy, or asleep; running out of medication;
wanting to avoid side effects; and feeling well enough
not to "need" the medicine. More than 80% of
adherent women understood that their medications were
supposed to reduce viral load, compared with 47% of
nonadherent women. However, only about half in both
groups understood the effect their medication should
have on CD4 T-cell counts. Interventions to improve
adherence to treatment for HIV-positive patients need to
focus on education about medication effects and building
medication schedules into the daily routine.
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