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Comparison of Antiretroviral Adherence Questions

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Abstract

Our objective was to compare antiretroviral adherence questions to better understand concordance between measures. Among 53 methadone maintained HIV-infected drug users, we compared five measures, including two single item measures using qualitative Likert-type responses, one measure of percent adherence, one visual analog scale, and one multi-item measure that averaged responses across antiretrovirals. Responses were termed inconsistent if respondents endorsed the highest adherence level on at least one measure but middle levels on others. We examined ceiling effects, concordance, and correlations with VL. Response distributions differed markedly between measures. A ceiling effect was less pronounced for the single-item measures than for the measure that averaged responses for each antiretroviral: the proportion with 100% adherence varied from 22% (single item measure) to 58% (multi-item measure). Overall agreement between measures ranged from fair to good; 49% of participants had inconsistent responses. Though responses correlated with VL, single-item measures had higher correlations. Future studies should compare single-item questions to objective measures.

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Acknowledgments

This work was funded by National Institutes of Health grants R01 DA015302 and R25 DA023021 awarded to Dr. Arnsten, K24 RR020300 awarded to Dr. Wilson, K23 DA021087 awarded to Dr. Berg, and a Center for AIDS Research grant (P30 A1051519) awarded to the Albert Einstein College of Medicine of Yeshiva University. Dr. Berg was also supported by a Robert Wood Johnson Physician Faculty Scholar Award. We would like to thank Elise Duggan, Uri Goldberg, and Amanda Carter for help with data collection and manuscript preparation, and the members of the Substance Abuse Affinity Group in the Einstein/Montefiore Division of General Internal Medicine for their comments on manuscript drafts.

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Authors and Affiliations

  1. Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA

    Karina M. Berg, Xuan Li & Julia H. Arnsten

  2. Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA

    Karina M. Berg & Julia H. Arnsten

  3. Program on Public Health, Warren Alpert School of Medicine, Brown University, Providence, RI, USA

    Ira B. Wilson

  4. Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA

    Julia H. Arnsten

Authors
  1. Karina M. Berg
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  2. Ira B. Wilson
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  3. Xuan Li
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  4. Julia H. Arnsten
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Correspondence to Karina M. Berg.

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Berg, K.M., Wilson, I.B., Li, X. et al. Comparison of Antiretroviral Adherence Questions. AIDS Behav 16, 461–468 (2012). https://doi.org/10.1007/s10461-010-9864-z

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