Adherence to HIV antiretroviral therapy is closely associated with HIV viral suppression, drug resistance development, disease progression, and death. A great deal has been learned about the measurements, correlates, and outcomes of adherence to antiretroviral therapy; yet, most of the current understanding is based on outdated, partially suppressive regimens with limited patient sample sizes. Important questions remain: a) How do the complexities of adherence behavior that are not captured by a simple percentage of missed doses influence virologic and clinical outcomes? b) Has the relationship between adherence and treatment outcomes changed with newer, longer half-life medications? c) Does adherence behavior determine whether patients develop either limited or multi-drug resistance mutations? d) How do different adherence intervention strategies compare with each other? and e) How much adherence is necessary to prevent morbidity and mortality? The specific aims of this project are to: 1) capture the full range of complex adherence behavior with valid approaches, 2) examine patterns and identify predictors of adherence, 3) model treatment exposure and virologic outcomes, and 4) model treatment exposure and clinical outcomes.
Principal Investigator: Carol E. Golin, M.D., M.P.H.
Funding Source: National Institute of Mental Health, NIH (subcontract with The Regents of the University of California)
Total Project Period: 07/07 – 06/2013