Psychosocial predictors of non-adherence and treatment failure in a large scale multi-national trial of antiretroviral therapy for HIV: Data from the ACTG A5175/PEARLS trial

Steven Safren, Katie B. Biello, Laura Smeaton, Matthew J. Mimiaga, Ann Walawander, Javier R. Lama, Aadia Rana, Mulinda Nyirenda, Virginia M. Kayoyo, Wadzanai Samaneka, Anjali Joglekar, David Celentano, Ana Martinez, Jocelyn E. Remmert, Aspara Nair, Umesh G. Lalloo, Nagalingeswaran Kumarasamy, James Hakim, Thomas B. Campbell

Research output: Contribution to journalArticle

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Abstract

Background: PEARLS, a large scale trial of antiretroviral therapy (ART) for HIV (n = 1,571, 9 countries, 4 continents), found that a once-daily protease inhibitor (PI) based regimen (ATV+DDI+FTC), but not a once-daily non-nucleoside reverse transcriptase inhibitor/nucleoside reverse transcriptase inhibitor (NNRTI/NRTI) regimen (EFV+FTC/TDF), had inferior efficacy compared to a standard of care twice-daily NNRTI/NRTI regimen (EFV+3TC/ZDV). The present study examined non-adherence in PEARLS. Methods: Outcomes: non-adherence assessed by pill count and by self-report, and time to treatment failure. Longitudinal predictors: regimen, quality of life (general health perceptions = QOL-health, mental health = QOL-mental health), social support, substance use, binge drinking, and sexual behaviors. "Life-Steps" adherence counseling was provided. Results: In both pill-count and self-report multivariable models, both once-a-day regimens had lower levels of non-adherence than the twice-a-day standard of care regimen; although these associations attenuated with time in the self-report model. In both multivariable models, hard-drug use was associated with non-adherence, living in Africa and better QOL-health were associated with less non-adherence. According to pill-count, unprotected sex was associated with non-adherence. According to self-report, soft-drug use was associated with non-adherence and living in Asia was associated with less non-adherence. Both pill-count (HR = 1.55, 95% CI: 1.15, 2.09, p

Original languageEnglish (US)
Article numbere104178
JournalPLoS One
Volume9
Issue number8
DOIs
StatePublished - Aug 25 2014
Externally publishedYes

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Reverse Transcriptase Inhibitors
RNA-directed DNA polymerase
Treatment Failure
Self Report
Health
HIV
therapeutics
mental health
nucleosides
Standard of Care
Nucleosides
Mental Health
Binge Drinking
Unsafe Sex
drugs
Drinking Behavior
binging
Lamivudine
counseling
sexual behavior

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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Psychosocial predictors of non-adherence and treatment failure in a large scale multi-national trial of antiretroviral therapy for HIV : Data from the ACTG A5175/PEARLS trial. / Safren, Steven; Biello, Katie B.; Smeaton, Laura; Mimiaga, Matthew J.; Walawander, Ann; Lama, Javier R.; Rana, Aadia; Nyirenda, Mulinda; Kayoyo, Virginia M.; Samaneka, Wadzanai; Joglekar, Anjali; Celentano, David; Martinez, Ana; Remmert, Jocelyn E.; Nair, Aspara; Lalloo, Umesh G.; Kumarasamy, Nagalingeswaran; Hakim, James; Campbell, Thomas B.

In: PLoS One, Vol. 9, No. 8, e104178, 25.08.2014.

Research output: Contribution to journalArticle

Safren, S, Biello, KB, Smeaton, L, Mimiaga, MJ, Walawander, A, Lama, JR, Rana, A, Nyirenda, M, Kayoyo, VM, Samaneka, W, Joglekar, A, Celentano, D, Martinez, A, Remmert, JE, Nair, A, Lalloo, UG, Kumarasamy, N, Hakim, J & Campbell, TB 2014, 'Psychosocial predictors of non-adherence and treatment failure in a large scale multi-national trial of antiretroviral therapy for HIV: Data from the ACTG A5175/PEARLS trial', PLoS One, vol. 9, no. 8, e104178. https://doi.org/10.1371/journal.pone.0104178
Safren, Steven ; Biello, Katie B. ; Smeaton, Laura ; Mimiaga, Matthew J. ; Walawander, Ann ; Lama, Javier R. ; Rana, Aadia ; Nyirenda, Mulinda ; Kayoyo, Virginia M. ; Samaneka, Wadzanai ; Joglekar, Anjali ; Celentano, David ; Martinez, Ana ; Remmert, Jocelyn E. ; Nair, Aspara ; Lalloo, Umesh G. ; Kumarasamy, Nagalingeswaran ; Hakim, James ; Campbell, Thomas B. / Psychosocial predictors of non-adherence and treatment failure in a large scale multi-national trial of antiretroviral therapy for HIV : Data from the ACTG A5175/PEARLS trial. In: PLoS One. 2014 ; Vol. 9, No. 8.
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abstract = "Background: PEARLS, a large scale trial of antiretroviral therapy (ART) for HIV (n = 1,571, 9 countries, 4 continents), found that a once-daily protease inhibitor (PI) based regimen (ATV+DDI+FTC), but not a once-daily non-nucleoside reverse transcriptase inhibitor/nucleoside reverse transcriptase inhibitor (NNRTI/NRTI) regimen (EFV+FTC/TDF), had inferior efficacy compared to a standard of care twice-daily NNRTI/NRTI regimen (EFV+3TC/ZDV). The present study examined non-adherence in PEARLS. Methods: Outcomes: non-adherence assessed by pill count and by self-report, and time to treatment failure. Longitudinal predictors: regimen, quality of life (general health perceptions = QOL-health, mental health = QOL-mental health), social support, substance use, binge drinking, and sexual behaviors. {"}Life-Steps{"} adherence counseling was provided. Results: In both pill-count and self-report multivariable models, both once-a-day regimens had lower levels of non-adherence than the twice-a-day standard of care regimen; although these associations attenuated with time in the self-report model. In both multivariable models, hard-drug use was associated with non-adherence, living in Africa and better QOL-health were associated with less non-adherence. According to pill-count, unprotected sex was associated with non-adherence. According to self-report, soft-drug use was associated with non-adherence and living in Asia was associated with less non-adherence. Both pill-count (HR = 1.55, 95{\%} CI: 1.15, 2.09, p",
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T1 - Psychosocial predictors of non-adherence and treatment failure in a large scale multi-national trial of antiretroviral therapy for HIV

T2 - Data from the ACTG A5175/PEARLS trial

AU - Safren, Steven

AU - Biello, Katie B.

AU - Smeaton, Laura

AU - Mimiaga, Matthew J.

AU - Walawander, Ann

AU - Lama, Javier R.

AU - Rana, Aadia

AU - Nyirenda, Mulinda

AU - Kayoyo, Virginia M.

AU - Samaneka, Wadzanai

AU - Joglekar, Anjali

AU - Celentano, David

AU - Martinez, Ana

AU - Remmert, Jocelyn E.

AU - Nair, Aspara

AU - Lalloo, Umesh G.

AU - Kumarasamy, Nagalingeswaran

AU - Hakim, James

AU - Campbell, Thomas B.

PY - 2014/8/25

Y1 - 2014/8/25

N2 - Background: PEARLS, a large scale trial of antiretroviral therapy (ART) for HIV (n = 1,571, 9 countries, 4 continents), found that a once-daily protease inhibitor (PI) based regimen (ATV+DDI+FTC), but not a once-daily non-nucleoside reverse transcriptase inhibitor/nucleoside reverse transcriptase inhibitor (NNRTI/NRTI) regimen (EFV+FTC/TDF), had inferior efficacy compared to a standard of care twice-daily NNRTI/NRTI regimen (EFV+3TC/ZDV). The present study examined non-adherence in PEARLS. Methods: Outcomes: non-adherence assessed by pill count and by self-report, and time to treatment failure. Longitudinal predictors: regimen, quality of life (general health perceptions = QOL-health, mental health = QOL-mental health), social support, substance use, binge drinking, and sexual behaviors. "Life-Steps" adherence counseling was provided. Results: In both pill-count and self-report multivariable models, both once-a-day regimens had lower levels of non-adherence than the twice-a-day standard of care regimen; although these associations attenuated with time in the self-report model. In both multivariable models, hard-drug use was associated with non-adherence, living in Africa and better QOL-health were associated with less non-adherence. According to pill-count, unprotected sex was associated with non-adherence. According to self-report, soft-drug use was associated with non-adherence and living in Asia was associated with less non-adherence. Both pill-count (HR = 1.55, 95% CI: 1.15, 2.09, p

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