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Adherence to Highly Active Antiretroviral Therapy (HAART): A Meta-Analysis

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Abstract

This meta-analysis synthesizes eighty-four observational studies, conducted across twenty countries, to determine the mean proportion of people who reported ≥90% adherence to prescribed highly active antiretroviral therapy (HAART) and to identify the factors associated with high levels of adherence. Eight electronic databases were searched to locate all relevant studies available by January 2010, which were then coded for sample characteristics and adherence levels. The average rate of reporting ≥90% adherent HAART adherence is 62%. However, this proportion varies greatly across studies. In particular, a greater proportion of individuals maintaining ≥90% adherence to HAART is more likely in studies with higher proportions of men who have sex with men (MSM) and lower proportions of injection drug users (IDU), with participants in an earlier stage of infection, and in studies conducted in countries characterized by lower Human Development Index (HDI) scores.

Resumen

Este metaanálisis sintetiza ochenta y cuatro estudios observacionales, realizados en veinte países, para determinar la proporción media de personas que informan de la adherencia a la Terapia Antirretroviral Altamente Activa ≥90% e identificar los factores relacionados con los niveles elevados de adherencia. Para localizar los estudios relevantes disponibles hasta enero de 2010 accedimos a ocho bases de datos electrónicas. Los estudios seleccionados se codificaron según las características de la muestra y los niveles de adherencia. Los resultados obtenidos indican que una media del 62% de las personas que tomaban Terapia Antirretroviral Altamente Activa eran adherentes en un ≥90%. Sin embargo, esta proporción varía enormemente entre los estudios. En particular, una mayor proporción de individuos que muestran una adherencia a la Terapia Antirretroviral Altamente Activa ≥90% es más frecuente en estudios con altas proporciones de hombres que mantienen relaciones sexuales con hombres y con menores proporciones de usuarios de drogas parenterales, con los participantes en un estadio más temprano de la infección y en estudios llevados a cabo en países caracterizados con puntuaciones más bajas en el índice de desarrollo humano.

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Acknowledgments

We thank those study authors who made their data available for this study, SHARP (Synthesis of HIV/AIDS Research Project) team for its assistance on using the structural variables included in the study, and Soledad Fernandez who checked the English translation. This work was funded by the Fundación Marqués de Valdecilla (IFIMAV). Santander. Spain. N/Ref.: PSG10/02.

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The authors indicate having no conflicts of interest.

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Correspondence to Carmen Ortego.

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This work was presented at XIII AIDS National Conference. 16–18 June 2010. Santiago de Compostela (Spain).

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Ortego, C., Huedo-Medina, T.B., Llorca, J. et al. Adherence to Highly Active Antiretroviral Therapy (HAART): A Meta-Analysis. AIDS Behav 15, 1381–1396 (2011). https://doi.org/10.1007/s10461-011-9942-x

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