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Pharmacy and Self-Report Adherence Measures to Predict Virological Outcomes for Patients on Free Antiretroviral Therapy in Tamil Nadu, India

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Abstract

Over 480,000 individuals receive free antiretroviral therapy (ART) in India yet data associating ART adherence with HIV viral load for populations exclusively receiving free ART are not available. Additionally estimates of adherence using pharmacy data on ART pick-up are not available for any population in India. After 12-months ART we found self-reported estimates of adherence were not associated with HIV viral load. Individuals with <100 % adherence using pharmacy data predicted HIV viral load, and estimates combining pharmacy data and self-report were also predictive. Pharmacy adherence measures proved a feasible method to estimate adherence in India and appear more predictive of virological outcomes than self-report. Predictive adherence measures identified in this study warrant further investigation in populations receiving free ART in India to allow for identification of individuals at risk of virological failure and in need of adherence support.

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Acknowledgments

We thank the study participants and all staff within the NACO sponsored ART Clinic at Christian Medical College (ACTFID).

Conflict of interest

SRL receives payment for lectures (Viiv Healthcare and Janssen), payment for educational presentations (Janssen) and SRL’s institution receives grant funding (Merck and Gilead). All other authors, no conflicts.

Funding sources

JM was supported by a fellowship from Tufts Medical Center Department of Geographic Medicine and Infectious Diseases, and an Australian National Health and Medical Research Council (NHMRC) Postgraduate Scholarship. The study was supported by a Lifespan/Tufts/Brown Center for AIDS Research NIH Grant (1P30A142853-12). AM was supported by a Fogarty International Center training Grant (5D43TW000237-15). MRJ was supported by an NIH Career Development Award (5K23AI074423-04). SRL is an NHMRC Practitioner Fellow.

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Authors and Affiliations

  1. Infectious Diseases Unit, Alfred Hospital, Level 2 Burnet Tower, 85 Commercial Road, Melbourne, 3004, Australia

    James H. McMahon, Julian H. Elliott & Sharon R. Lewin

  2. Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA

    James H. McMahon, Christine A. Wanke & Michael R. Jordan

  3. Department of Medicine and Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India

    Anand Manoharan, Hepsibah Jose, Thabeetha Malini, Tony Kadavanu & Dilip Mathai

  4. Department of Clinical Virology, Christian Medical College, Vellore, Tamil Nadu, India

    Shoba Mammen

  5. Department of Medicine, Monash University, Melbourne, VIC, Australia

    Julian H. Elliott & Sharon R. Lewin

  6. Burnet Institute, Melbourne, VIC, Australia

    Julian H. Elliott & Sharon R. Lewin

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  1. James H. McMahon
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  2. Anand Manoharan
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  3. Christine A. Wanke
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  9. Julian H. Elliott
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Correspondence to James H. McMahon.

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McMahon, J.H., Manoharan, A., Wanke, C.A. et al. Pharmacy and Self-Report Adherence Measures to Predict Virological Outcomes for Patients on Free Antiretroviral Therapy in Tamil Nadu, India. AIDS Behav 17, 2253–2259 (2013). https://doi.org/10.1007/s10461-013-0436-x

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