Self-Report and Dry Blood Spot Measurement of Antiretroviral Medications as Markers of Adherence in Pregnant Women in Rural South Africa

AIDS Behav. 2017 Jul;21(7):2135-2140. doi: 10.1007/s10461-017-1760-3.

Abstract

Antiretroviral (ARV) adherence is essential to prevent mother-to-child transmission of HIV. This study compared self-reported adherence versus ARV detection in dried blood spots (DBS) among N = 392 HIV-infected pregnant women in South Africa (SA). Women completed two self-reported adherence measures [visual analog scale (VAS), AIDS Clinical Trials Group Adherence (ACTG)]. Adherence was 89% (VAS), 80% (ACTG), and 74% (DBS). Self-report measures marginally agreed with DBS (VAS: Kappa = 0.101, Area under the ROC curve (AUROC) = 0.543; ACTG: Kappa = 0.081, AUROC = 0.538). Self-reported adherence was overestimated and agreement with DBS was poor. Validation of self-reported ARV adherence among pregnant HIV+ women in SA is needed.

Keywords: Adherence; Antiretrovirals; HIV; Measurement; South Africa; Women.

MeSH terms

  • Adult
  • Anti-HIV Agents / blood*
  • Anti-HIV Agents / therapeutic use
  • Female
  • HIV Infections / drug therapy*
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Medication Adherence*
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Rural Population
  • Self Report*
  • South Africa
  • Visual Analog Scale
  • Young Adult

Substances

  • Anti-HIV Agents