Imperial College London
Alternate

ProfessorSimonGregson

Faculty of Medicine, School of Public Health

Professor in Demography and Behavioural Science
 
 
 
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Contact

 

+44 (0)20 7594 3279s.gregson

 
 
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Location

 

LG27Praed StreetSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Rhead:2016:10.1371/journal.pone.0167852,
author = {Rhead, RD and Masimirembwa, C and Cooke, G and Takaruza, A and Nyamukapa, C and Gregson, S},
doi = {10.1371/journal.pone.0167852},
journal = {PLOS One},
title = {Might ART adherence estimates be improved by combining biomarker and self-report data?},
url = {http://dx.doi.org/10.1371/journal.pone.0167852},
volume = {11},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundAs we endeavour to examine rates of viral suppression in PLHIV, reliable data on ART adherence are needed to distinguish between the respective contributions of poor adherence and treatment failure on high viral load. Self-reported data are susceptible to response bias and although biomarker data on drug presence and concentration can provide a superior, alternative method of measurement, complications due to drug-drug interactions and genetic variations can cause some inaccuracies. We investigate the feasibility of combining both biomarker and self-report data to produce a potentially more accurate measure of ART adherence.MethodsData were taken from a large general-population survey in the Manicaland province, Zimbabwe, conducted in 2009–2011. HIV-infected adults who had initiated ART (N = 560) provided self-report data on adherence and dried blood spot samples that were analysed for traces of ART medication. A new three-category measure of ART adherence was constructed, based on biomarker data but using self-report data to adjust for cases with abnormally low and high drug concentrations due to possible drug-drug interactions and genetic factors, and was assessed for plausibility using survey data on socio-demographic correlates.Results94.3% (528/560) and 92.7% (519/560) of the sample reported faithful adherence to their medication and had traces of ART medication, respectively. The combined measure estimated good evidence of ART adherence at 69% and excellent evidence of adherence at 53%. The regression analysis results showed plausible patterns of ART adherence by socio-demographic status with men and younger participants being more likely to adhere poorly to medication, and higher socio-economic status individuals and those living in more urban locations being more likely to adhere well.ConclusionBiomarker and self-reported measures of adherence can be combined in a meaningful way to produce a potentially more accurate measure of ART adherence.
AU  - Rhead,RD
AU  - Masimirembwa,C
AU  - Cooke,G
AU  - Takaruza,A
AU  - Nyamukapa,C
AU  - Gregson,S
DO  - 10.1371/journal.pone.0167852
PY  - 2016///
SN  - 1932-6203
TI  - Might ART adherence estimates be improved by combining biomarker and self-report data?
T2  - PLOS One
UR  - http://dx.doi.org/10.1371/journal.pone.0167852
UR  - http://hdl.handle.net/10044/1/43255
VL  - 11
ER  -
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