Young HIV-Infected Adults Are at Greater Risk for Medication Nonadherence

Stephen L. Becker, MD; Christopher M. Dezii, RN, MBA; Beth Burtcel, PharmD; Hugh Kawabata, MA; Sally Hodder, MD

In This Article


A total of 24,845 individuals with an NRTI prescription were identified. Upon application of the required screening period and eligibility criteria, 3788 individuals were studied. Sample determination based on the inclusion/exclusion criteria is depicted in Table 1 . Of the 3788 subjects, 2606 (69%) were men and 1182 (31%) were women.

While all patients were exposed to NRTI therapy by virtue of the study design, Figure 1 illustrates the exposure to coadministered classes during the entire study period.

Exposure to NRTIs, NNRTIs, and PIs during the study period.

Overall, the mean adherence rate during the year of study was 53.0%. The overall proportion of patients with adherence rates of 80% or higher was 26%. The distribution of patients according to their degree of adherence revealed a fairly flat curve across all categories < 80%, as shown in Figure 2.

Distribution of patients across adherence strata.

A total of 1349 of the 3788 (35.6%) patients were persistent with therapy at 12 months. The constructed persistence curve (Figure 3) illustrates that a significant proportion (approximately 50%) of patients failed to persist with therapy beyond the first 6 months, as defined in this study.

Persistence with NRTI therapy during the 12 months after initiation.

The mean adherence rates were 53.6% for men and 51.8% for women. This difference was not statistically significant (P = .30). In addition, there were no significant differences in persistence with therapy at 12 months between men (36.1%) and women (34.5%). Mean rates of adherence and persistence at 12 months, stratified by age, are depicted in Table 2 . Differences between age stratifications were found to be statistically significant (P < .001) by ANOVA between all strata using an f test. Age groups were then evaluated by sex to determine whether any differences in adherence would be detected. Age was again revealed to be significant (P = .001) while sex was not.