Factors associated with non-adherence to antiretroviral therapy in the SUN study

Abstract Background. Adherence of 95% or greater to highly active combination antiretroviral therapy is generally considered necessary to achieve optimal virologic suppression in HIV-infected patients. Understanding factors associated with poor adherence is essential to improve patient compliance, maximize virologic suppression, and reduce morbidity and mortality. Methods. We evaluated baseline data from 528 patients taking antiretrovirals, enrolled from March 2004 to June 2006, in a multicenter, longitudinal, prospective cohort study (the SUN study). Using multiple logistic regression, we examined independent risk factors for non-adherence, defined as reporting having missed one or more antiretroviral doses in the past three days on the baseline questionnaire. Results. Of 528 participants (22% female, 28% black, median age 41 years, and median CD4 cell count 486 cells/mm3), 85 (16%) were non-adherent. In the final parsimonious multivariate model, factors independently associated with non-adherence includ...