Abstract
Clinic-based pill counts of unused study medication are frequently used to measure adherence in HIV-1 prevention trials. Monthly
pill count adherence data from the Partners in Prevention HSV/HIV Transmission Study, a double-blind, placebo controlled trial
of twice-daily acyclovir suppression of herpes simplex virus type 2 (HSV-2) in HIV-1 infected persons was used to compare
changes between 3,381 placebo and active arm participants in two objective biologic measures of acyclovir’s drug activity:
reduction in plasma HIV-1 RNA and HSV-2 genital ulcer disease (GUD). Higher acyclovir pill count adherence was associated
with greater reductions in plasma HIV-1 RNA and GUD, indicating pill count data is strongly correlated with biological effects
of adherence. However, when calculated adherence exceeded 102 % (i.e., fewer pills returned than expected) and when pill counts
were missing because bottles were not returned, plasma HIV-1 RNA and GUD effects were diminished, likely indicating periods
of non-adherence.
pill count adherence data from the Partners in Prevention HSV/HIV Transmission Study, a double-blind, placebo controlled trial
of twice-daily acyclovir suppression of herpes simplex virus type 2 (HSV-2) in HIV-1 infected persons was used to compare
changes between 3,381 placebo and active arm participants in two objective biologic measures of acyclovir’s drug activity:
reduction in plasma HIV-1 RNA and HSV-2 genital ulcer disease (GUD). Higher acyclovir pill count adherence was associated
with greater reductions in plasma HIV-1 RNA and GUD, indicating pill count data is strongly correlated with biological effects
of adherence. However, when calculated adherence exceeded 102 % (i.e., fewer pills returned than expected) and when pill counts
were missing because bottles were not returned, plasma HIV-1 RNA and GUD effects were diminished, likely indicating periods
of non-adherence.
- Content Type Journal Article
- Category Original Paper
- Pages 1-8
- DOI 10.1007/s10461-012-0268-0
- Authors
- Deborah J. Donnell, Department of Global Health, University of Washington, Seattle, WA, USA
- Jared M. Baeten, Department of Global Health, University of Washington, Seattle, WA, USA
- Ting Hong, Department of Global Health, University of Washington, Seattle, WA, USA
- Jairam R. Lingappa, Department of Global Health, University of Washington, Seattle, WA, USA
- Andrew Mujugira, Department of Global Health, University of Washington, Seattle, WA, USA
- Edith Nakku-Joloba, Department of Global Health, University of Washington, Seattle, WA, USA
- David Bangsberg, Harvard Medical School, Boston, MA, USA
- Connie Celum, Department of Global Health, University of Washington, Seattle, WA, USA
- Journal AIDS and Behavior
- Online ISSN 1573-3254
- Print ISSN 1090-7165