Cited by 1,428HIV/AIDS Research and InterventionsMedication Adherence and ComplianceHIV/AIDS drug development and treatment

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Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The AACTG Adherence Instruments

Chesney, M. A., Ickovics, J. R., Chambers, D. B., Gifford, A. L., Neidig, J., Zwickl, B., Wu, A. W., PATIENT CARE COMMITTEE & ADHERENCE·2000·AIDS Care

DOI 10.1080/09540120050042891

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Abstract

This paper describes the AACTG Adherence Instruments, which are comprised of two self-report questionnaires for use in clinical trials conducted by the Adult AIDS Clinical Trials Group (AACTG). The questionnaires were administered to 75 patients at ten AACTG sites in the USA. All patients were taking combination antiretroviral therapy (ART), including at least one protease inhibitor. Eleven per cent of patients reported missing at least one dose the day before the interview, and 17% reported missing at least one dose during the two days prior. The most common reasons for missing medications included 'simply forgot' (66%) and a number of factors often associated with improved health, including being busy (53%), away from home (57%) and changes in routine (51%). Less adherent patients reported lower adherence self-efficacy (p = 0.006) and were less sure of the link between non-adherence and the development of drug resistance (p = 0.009). They were also more likely to consume alcohol, to be employed outside the home for pay and to have enrolled in clinical trials to gain access to drugs (all p < 0.05). Twenty-two per cent of patients taking drugs requiring special instructions were unaware of these instructions. Each questionnaire took approximately ten minutes to complete. Responses to the questionnaires were favourable. These questionnaires have been included in six AACTG clinical trials to date and have been widely disseminated to investigators both in the USA and abroad.

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A randomized controlled trial of a peer support intervention targeting antiretroviral medication adherence and depressive symptomatology in HIV-positive men and women.
Simoni, J. M., Pantalone, D. W., Plummer, M. D., & Huang, B. (2007) · Health Psychology · doi:10.1037/0278-6133.26.4.488 · Cited by 174
“Depressive symptomatology is a potentially potent intervention target because of its consistent association with nonadherence among HIV-positive individuals (Chesney et al., 2000; Gordillo et al., 1999; Paterson et al., 2000; Treisman, Angelino, & Hutton, 2001).”
BackgroundMethod
Positive Provider Interactions, Adherence Self-Efficacy, and Adherence to Antiretroviral Medications Among HIV-Infected Adults: A Mediation Model
Johnson, M. O., Chesney, M. A., Goldstein, R. B., Remien, R. H., Catz, S., Gore-Felton, C., Charlebois, E., Morin, S. F., & NIMH Healthy Living Project Team (2006) · AIDS Patient Care and STDs · doi:10.1089/apc.2006.20.258 · Cited by 170
“3–6 One patient factor that is consistently and meaningfully related to ARV medication adherence is adherence self efficacy, 5,7–12 or confidence in one’s ability to adhere to a treatment regimen in the face of challenges such as side effects, interference with daily activities, environmental…”
Self-citation
Behavioral Health Risks in Perinatally HIV-Exposed Youth: Co-Occurrence of Sexual and Drug Use Behavior, Mental Health Problems, and Nonadherence to Antiretroviral Treatment
Mellins, C. A., Tassiopoulos, K., Malee, K., Moscicki, A., Patton, D. E., Smith, R. A., Usitalo, A., Allison, S. M., Dyke, R. V., & Seage, F. T. P. H.-A. G. R. (2011) · AIDS Patient Care and STDs · doi:10.1089/apc.2011.0025 · Cited by 170
“Adherence to ART (for PHIV + youth) was assessed with a questionnaire developed by the AMP team, based on the work of the Adult and Pediatric AIDS Clinical Trials Groups.”
Mental disorders and drug abuse in persons living with HIV/AIDS
Klinkenberg, W. D., Sacks, S., & Adherenc, F. T. H. A. T. (2004) · AIDS Care · doi:10.1080/09540120412331315303 · Cited by 170
“Adherence is lower among heavy drinkers (Chesney et al., 2000; Tucker et al., 2003; Wagner et al., 2001), recent users of cocaine, marijuana, amphetamines, or sedatives (Tucker et al., 2003), and presence of depression, generalized anxiety disorders, or panic disorder (Tucker et al., 2003).”
Background
Ritonavir-boosted lopinavir plus nucleoside or nucleotide reverse transcriptase inhibitors versus ritonavir-boosted lopinavir plus raltegravir for treatment of HIV-1 infection in adults with virological failure of a standard first-line ART regimen (SECOND-LINE): a randomised, open-label, non-inferiority study
* (2013) · The Lancet · doi:10.1016/s0140-6736(13)61164-2 · Cited by 169
The CASE adherence index: A novel method for measuring adherence to antiretroviral therapy
Mannheimer, S. B., Mukherjee, R., Hirschhorn, L. R., Dougherty, J., Celano, S. A., Ciccarone, D., Graham, K. K., Mantell, J. E., Mundy, L. M., Eldred, L., et al. (2006) · AIDS Care · doi:10.1080/09540120500465160 · Cited by 166
“We compared the CASE Adherence Index and its individual components to a three-day self-report originally developed by Chesney, et al. (2000) for the AACTG.”
MethodInfluential
Predictors of antiretroviral adherence
Murphy, D. A., Marelich, W. D., Hoffman, D., & Steers, W. N. (2004) · AIDS Care · doi:10.1080/09540120410001683402 · Cited by 164
Levels of Adherence Required for Virologic Suppression Among Newer Antiretroviral Medications
Kobin, A. B., & Sheth, N. U. (2011) · Annals of Pharmacotherapy · doi:10.1345/aph.1p587 · Cited by 167
Interventions to improve antiretroviral therapy adherence among adolescents in low- and middle-income countries: A systematic review of the literature
Ridgeway, K., Dulli, L., Murray, K., Silverstein, H. A., Santo, L. D., Olsen, P., Mora, D. D. D., & McCarraher, D. R. (2018) · PLoS ONE · doi:10.1371/journal.pone.0189770 · Cited by 165
Randomized Clinical Trial of Cognitive Behavioral Stress Management on Human Immunodeficiency Virus Viral Load in Gay Men Treated With Highly Active Antiretroviral Therapy
Antoni, M. H., Carrico, A. W., Durán, R. E., Spitzer, S. B., Penedo, F. J., Ironson, G. H., FLETCHER, M. A., Klimas, N. G., & Schneiderman, N. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000195749.60049.63 · Cited by 167
“These data highlight, as other investigators have noted, that each measure of adherence possesses relative strengths and limitations (26,35).”
MethodResult
Adherence to antiretroviral therapy: An empirical test of the information-motivation-behavioral skills model.
Starace, F., Massa, A., Amico, K. R., & Fisher, J. D. (2006) · Health Psychology · doi:10.1037/0278-6133.25.2.153 · Cited by 165
An empirical test of the Information, Motivation and Behavioral Skills model of antiretroviral therapy adherence
Amico, K. R., Toro-Alfonso, J., & Fisher, J. D. (2005) · AIDS Care · doi:10.1080/09540120500038058 · Cited by 164
“In addition, a modified version of the Adherence to Combination Therapy Questionnaire (AACTG) (Chesney et al., 2000) was used to assess rates of ART adherence.”
MethodInfluential
Adherence to HAART among patients with HIV: Breakthroughs and barriers
Ickovics, J. R., & Meade, C. (2002) · AIDS Care · doi:10.1080/09540120220123685 · Cited by 185
Self-citation
Voucher reinforcement improves medication adherence in HIV-positive methadone patients: A randomized trial
Sorensen, J. L., Haug, N. A., Delucchi, K., Gruber, V. A., Kletter, E., Batki, S. L., Tulsky, J. P., Barnett, P. G., & Hall, S. M. (2006) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2006.09.019 · Cited by 163
Health Care Transition for Youth Living With HIV/AIDS
Dowshen, N., & D’Angelo, L. J. (2011) · PEDIATRICS · doi:10.1542/peds.2011-0068 · Cited by 162
HIV-infected pregnant women and vertical transmission in Europe since 1986
Study, E. C. (2001) · AIDS · doi:10.1097/00002030-200104130-00012 · Cited by 161
Evaluation of the Single-Item Self-Rating Adherence Scale for Use in Routine Clinical Care of People Living with HIV
Feldman, B. J., Fredericksen, R. J., Crane, P. K., Safren, S. A., Mugavero, M. J., Willig, J. H., Simoni, J. M., Wilson, I. B., Saag, M. S., Kitahata, M. M., et al. (2012) · AIDS and Behavior · doi:10.1007/s10461-012-0326-7 · Cited by 159
“In addition to the SRSI [39], patients responded to a number of additional widely used medication adherence items including a 30-day VAS [27, 50], and several Adult AIDS Clinical Trial Group (AACTG) adherence items [27, 51].”
Method
Effect of Adherence to HAART on Virologic Outcome and on the Selection of Resistance-Conferring Mutations in NNRTI- or PI-Treated Patients
Maggiolo, F., Airoldi, M., Kleinloog, H. D., Callegaro, A., Ravasio, V., Arici, C., Bombana, E., & Suter, F. (2007) · HIV Clinical Trials · doi:10.1310/hct0805-282 · Cited by 157
Uptake, engagement, and adherence to pre-exposure prophylaxis offered after population HIV testing in rural Kenya and Uganda: 72-week interim analysis of observational data from the SEARCH study
Koss, C. A., Charlebois, E. D., Ayieko, J., Kwarisiima, D., Kabami, J., Balzer, L. B., Atukunda, M., Mwangwa, F., Peng, J., Mwinike, Y., et al. (2020) · The Lancet HIV · doi:10.1016/s2352-3018(19)30433-3 · Cited by 156
Efficacy of 400 mg efavirenz versus standard 600 mg dose in HIV-infected, antiretroviral-naive adults (ENCORE1): a randomised, double-blind, placebo-controlled, non-inferiority trial
† (2014) · The Lancet · doi:10.1016/s0140-6736(13)62187-x · Cited by 155
A Stress and Coping Model of Medication Adherence and Viral Load in HIV-Positive Men and Women on Highly Active Antiretroviral Therapy (HAART).
Weaver, K. E., Llabre, M. M., Durán, R. E., Antoni, M. H., Ironson, G. H., Penedo, F. J., & Schneiderman, N. (2005) · Health Psychology · doi:10.1037/0278-6133.24.4.385 · Cited by 155
Antiretroviral Therapy Adherence Among Transgender Women Living With HIV
Sevelius, J. M., Carrico, A. W., & Johnson, M. O. (2010) · Journal of the Association of Nurses in AIDS Care · doi:10.1016/j.jana.2010.01.005 · Cited by 159
Association of Increased Chronicity of Depression With HIV Appointment Attendance, Treatment Failure, and Mortality Among HIV-Infected Adults in the United States
Pence, B. W., Mills, J. C., Bengtson, A. M., Gaynes, B. N., Breger, T. L., Cook, R. L., Moore, R. D., Grelotti, D. J., O’Cleirigh, C. M., & Mugavero, M. J. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.4726 · Cited by 155
Impact of a Patient Education Program on Adherence to HIV Medication
Goujard, C. C., Bernard, N., Sohier, N., Peyramond, D., on, F. L., Chwalow, J., Arnould, B., & Delfraissy, J.-F. O. (2003) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-200310010-00009 · Cited by 155
Optimizing Measurement of Self-Reported Adherence With the ACTG Adherence Questionnaire
Reynolds, N. R., Sun, J., Nagaraja, H. N., Gifford, A. L., Wu, A. W., & Chesney, M. A. (2007) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e318158a44f · Cited by 154
“Self-reported adherence was assessed with the ACTG Adherence Questionnaire.(2) The questionnaire queried the patient on the number of doses missed of a medication during each of the 4 days before a clinic visit (eg, ‘‘How many doses did you miss yesterday, the day before yesterday, 3 days ago, and 4 days ago?’’).”
MethodInfluentialSelf-citation
Longitudinal Study of Mental Health and Psychosocial Predictors of Medical Treatment Adherence in Mothers Living with HIV Disease
Mellins, C. A., Kang, E., Leu, C., Havens, J. F., & Chesney, M. A. (2003) · AIDS Patient Care and STDs · doi:10.1089/108729103322277420 · Cited by 154
Self-citation
Stigma and Endometriosis: A Brief Overview and Recommendations to Improve Psychosocial Well-Being and Diagnostic Delay
Sims, O. T., Gupta, J., Missmer, S. A., & Aninye, I. O. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18158210 · Cited by 185
HIV-Infected Patients Receiving Lopinavir/Ritonavir-Based Antiretroviral Therapy Achieve High Rates of Virologic Suppression Despite Adherence Rates Less Than 95%
Shuter, J., Sarlo, J. A., Kanmaz, T. J., Rode, R. A., & Zingman, B. S. (2007) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e318050d8c2 · Cited by 151
“At the week 24 study visit, subjects completed a previously validated Adult AIDS Clinical Trial Group (AACTG) adherence instrument, which quantitates adherence by 4-day recall.(10) Subjects who completed the baseline and week 24 visits and who had VL measurements at both time points were entered into the final analysi…”
Method
Efficacy of a nucleoside-sparing regimen of darunavir/ritonavir plus raltegravir in treatment-naive HIV-1-infected patients (ACTG A5262)
Taiwo, B., Zheng, L., Gallien, S., Matining, R. M., Kuritzkes, D. R., Wilson, C. C., Berzins, B., Acosta, E. P., Bastow, B., Kim, P. S., et al. (2011) · AIDS · doi:10.1097/qad.0b013e32834bbaa9 · Cited by 149
Dispositional optimism and the mechanisms by which it predicts slower disease progression in HIV: proactive behavior, avoidant coping, and depression
Ironson, G. H., Balbin, E., Stuetzle, R., FLETCHER, M. A., O’Cleirigh, C. M., Laurenceau, J., Schneiderman, N., & Solomon, G. F. (2005) · International Journal of Behavioral Medicine · doi:10.1207/s15327558ijbm1202_6 · Cited by 149
“Behaviors—Adherence was measured by the proportion of missed doses by self-report on the AIDS Clinical Trial Group (ACTG) adherence measure (Chesney et al., 2000).”
Method
Patient-Related Risks for Nonadherence to Antiretroviral Therapy among HIV-Infected Youth in the United States: A Study of Prevalence and Interactions
Rudy, B. J., Murphy, D. A., Harris, D. R., Muenz, L. R., & Ellen, J. M. (2009) · AIDS Patient Care and STDs · doi:10.1089/apc.2008.0162 · Cited by 149
“Adherence self-efficacy has been shown to positively correlate with adherence in patients prescribed HAART.(3,4,28) In a recent review, adherence self-efficacy was consistently associated with HAART adherence.”
Influential
Self-compassion and reactions to serious illness: The case of HIV
Brion, J. M., Leary, M. R., & Drabkin, A. S. (2013) · Journal of Health Psychology · doi:10.1177/1359105312467391 · Cited by 148
“Group (AACTG) 4-day recall adherence measure—total doses taken divided by total doses prescribed (Chesney et al., 2000).”
BackgroundMethodInfluential
Patterns of Marijuana Use Among Patients With HIV/AIDS Followed in a Public Health Care Setting
Prentiss, D., Power, R., Balmas, G., Tzuang, G., & Israelski, D. M. (2003) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-200401010-00005 · Cited by 148
Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence
Gonzalez, J. S., Penedo, F. J., Llabre, M. M., Durán, R. E., Antoni, M. H., Schneiderman, N., & Horne, R. (2007) · Annals of Behavioral Medicine · doi:10.1007/bf02879920 · Cited by 146
A systematic review of treatment fatigue among HIV-infected patients prescribed antiretroviral therapy
Claborn, K. R., Meier, E., Miller, M. B., & Leffingwell, T. R. (2015) · Psychology, Health & Medicine · doi:10.1080/13548506.2014.945601 · Cited by 166
“HIV treatment requires strict adherence and lifestyle changes, including integration into daily routine, coping with side effects, consistently obtaining prescription refills and attending medical appointments, and remembering to take medications throughout the patient’s life (Chesney et al., 2000; Friedland, 2006).”
Background
View of God as benevolent and forgiving or punishing and judgmental predicts HIV disease progression
Ironson, G. H., Stuetzle, R., Ironson, D., Balbin, E., Kremer, H., George, A., Schneiderman, N., & FLETCHER, M. A. (2011) · Journal of Behavioral Medicine · doi:10.1007/s10865-011-9314-z · Cited by 149
“Treatment adherence was assessed using the adherence questionnaire of the AIDS Clinical Trials Group, (Chesney et al. 2000).”
Method
Social Support, Substance Use, and Denial in Relationship to Antiretroviral Treatment Adherence among HIV-Infected Persons
Power, R., Koopman, C., Volk, J. E., Israelski, D. M., Stone, L., Chesney, M. A., & Spiegel, D. (2003) · AIDS Patient Care and STDs · doi:10.1089/108729103321655890 · Cited by 145
“19,20 Indeed, most assessment tools attempting to measure longer time periods (e.g., 1 week, 1 month) have been shown to contain more recall errors.”
Self-citation
Predictors of Antiretroviral Adherence as Measured by Self-Report, Electronic Monitoring, and Medication Diaries
Wagner, G. J. (2002) · AIDS Patient Care and STDs · doi:10.1089/108729102761882134 · Cited by 145
“…impact adherence, but while several studies have documented that “forgetfulness” is among the most frequently cited reasons for missed doses, 14,29,45 few studies have closely examined the relation between cognitive functioning and medication adherence using standardized testing instruments.”
A 2-Arm, Randomized, Controlled Trial of a Motivational Interviewing-Based Intervention to Improve Adherence to Antiretroviral Therapy (ART) Among Patients Failing or Initiating ART
Golin, C. E., Earp, J. A., Tien, H. C., Stewart, P. W., Porter, C. Q., & Howie, L. J. (2006) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/01.qai.0000219771.97303.0a · Cited by 144
Adherence to antiretroviral medications and medical care in HIV-infected adults diagnosed with mental and substance abuse disorders
Mellins, C., Havens, J., McDonnell, C., Lichtenstein, C., Uldall, K., Chesney, M., Santamaria, E., & Bell, J. (2009) · AIDS Care · doi:10.1080/09540120802001705 · Cited by 142
“Adherence was assessed using a modification of one of the most widely used self-report procedures, developed by Chesney and colleagues for the Adult AIDS Clinical Trials Group (AACTG: Chesney et al., 2000).”
BackgroundMethodSelf-citation
Changes in adherence to highly active antiretroviral therapy medications in the Multicenter AIDS Cohort Study*
Kleeberger, C. A., Buechner, J. M., Palella, F. J., Detels, R., Riddler, S. A., Godfrey, R., & Jacobson, L. P. (2004) · AIDS · doi:10.1097/00002030-200403050-00013 · Cited by 143
“therapeutic regimens, depression, alcohol and drug use, and changes in daily routines, may impact a patient’s ability to adhere to these medications [5,6], which may then compromise the effectiveness of HAART [3,7,8].”
Background
Supporting Adherence to Antiretroviral Therapy with Mobile Phone Reminders: Results from a Cohort in South India
Rodrigues, R., Shet, A., Antony, J., Sidney, K., Arumugam, K., Krishnamurthy, S., D'Souza, G., & DeCosta, A. (2012) · PLoS ONE · doi:10.1371/journal.pone.0040723 · Cited by 132
“Forgetfulness was the most common cause of non-adherence in our study and has been reported in literature [2,29,30].”
Result
Trust in Physicians and Racial Disparities in HIV Care
Saha, S., Jacobs, E. A., Moore, R. D., & Beach, M. C. (2010) · AIDS Patient Care and STDs · doi:10.1089/apc.2009.0288 · Cited by 139
Patterns and Predictors of Changes in Adherence to Highly Active Antiretroviral Therapy: Longitudinal Study of Men and Women
Lazo, M., Gange, S. J., Wilson, T. E., Anastos, K., Ostrow, D. G., Witt, M. D., & Jacobson, L. P. (2007) · Clinical Infectious Diseases · doi:10.1086/522762 · Cited by 139
“Adherence questionnaires recording self-reported adherence to all current antiretroviral drugs in the past 4 days in the MACS and in the past 3 days in the WIHS were introduced in both protocols starting in October 1998 and were based on the Adult AIDS Clinical Trials Group adherence measurement form [14].”
Method
Alcohol consumption and HIV disease progression: are they related?
Samet, J., Horton, N. J., Traphagen, E. T., Lyon, S. M., & Freedberg, K. (2003) · Alcoholism: Clinical and Experimental Research · doi:10.1097/01.alc.0000065438.80967.56 · Cited by 136
Psychiatric Risk Factors for HIV Disease Progression: The Role of Inconsistent Patterns of Antiretroviral Therapy Utilization
Carrico, A. W., Riley, E. D., Johnson, M. O., Charlebois, E. D., Neilands, T. B., Remien, R. H., Lightfoot, M. A., Steward, W. T., Weinhardt, L. S., Kelly, J. A., et al. (2010) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e318201df63 · Cited by 137
“Percentage of ART Doses Taken Self-reported percentage of ART doses taken during the past 3 days was measured at each assessment visit.(15) Using all available data provided by participants in 6 assessments over 25 months, the average self-reported percentage of pills taken was calculated.”
MethodSelf-citation
Mediators of Social Support and Antiretroviral Adherence Among an Indigent Population in New York City
Simoni, J. M., Frick, P. A., Lockhart, D., & Liebovitz, D. (2002) · AIDS Patient Care and STDs · doi:10.1089/108729102760330272 · Cited by 137
“19 Roberts 44 found that in-adequate patient knowledge was a main barrier reported by patients.”
Influential
Estimating the impact of alcohol consumption on survival for HIV+ individuals
Braithwaite, R. S., Conigliaro, J. C., Roberts, M. S., Shechter, S. M., Schaefer, A. J., McGinnis, K. A., Rodriguez, M. C., Rabeneck, L., BRYANT, K. J., & Justice, A. C. (2007) · AIDS Care · doi:10.1080/09540120601095734 · Cited by 137
“Alcohol consumption is the most prevalent risk factor for poor adherence to Highly Active Antiretroviral Therapy (HAART) among HIV-positive (HIV + ) individuals, with approximately half of all persons reporting recent use (Golin et al, 2002 ; Chesney et al, 2000 ) While the cross-sectional association is well establis…”
Background
Patient- and provider-reported adherence
Wagner, J. H., Justice, A. C., Chesney, M. A., Sinclair, G. I., Weissman, S., & Rodriguez‐Barradas, M. C. (2001) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(01)00450-4 · Cited by 136
“Margaret Chesney and Jeannette Ickovics for the Outcomes Committee of the Adult AIDS Clinical Trials group [20].”
BackgroundSelf-citation
Health-Related Quality of Life After 1 Year of Highly Active Antiretroviral Therapy
Carrieri, P., Spire, B., Duran, S., Katlama, C., Peyramond, D., François, C., Chêne, G., Lang, J.-M., Moatti, J., & Leport, C. (2003) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-200301010-00006 · Cited by 135
“Adherence measurement at M4 and M12 was based on 5 different questions according to the methodology established by the AIDS Clinical Trial Group (24) and has already been used in previous studies of the same cohort (25).”
Method
Treatment adherence in patients with rheumatoid arthritis and systemic lupus erythematosus
García-González, A., Richardson, M. N., Popa‐lisseanu, M. G. G., Cox, V., Kallen, M. A., Janssen, N. M., Ng, B., Marcus, D. M., Reveille, J. D., & Suarez-Almazor, M. E. (2008) · Clinical Rheumatology · doi:10.1007/s10067-007-0816-6 · Cited by 134
Effectiveness of Collaborative Care for Depression in Human Immunodeficiency Virus Clinics
Pyne, J. M., Fortney, J. C., Curran, G. M., Tripathi, S., Atkinson, J. H., Kilbourne, A. M., Hagedorn, H. J., Rimland, D., Rodriguez-Barradas, M. C., Monson, T., et al. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.395 · Cited by 132
“skipped taking for each medication for each of the past 4 days.(54) Percentage of adherence equaled the total number of prescribed pills taken divided by the total number prescribed during the past 4 days.”
Self-citation
Efficacy of an Educational and Counseling Intervention on Adherence to Highly Active Antiretroviral Therapy: French Prospective Controlled Study
Pradier, C., Laurence, B. L., Spire, B., Tourette-Turgis, C., Michel, M., Souville, M., Rébillon, M., Jean-Gabriel, F., Pesce, A., Dellamonica, P., et al. (2003) · HIV Clinical Trials · doi:10.1310/brbv-3941-h1pp-ndry · Cited by 131
Adherence to antiretroviral treatment among pregnant and postpartum HIV-infected women
Mellins, C. A., Chu, C. F. M., Malee, K., Allison, S., Smith, R., Harris, L. L., Higgins, A., Zorrilla, C. D. R., Landesman, S. H., Serchuck, L. K., et al. (2008) · AIDS Care · doi:10.1080/09540120701767208 · Cited by 130
“Adherence to ART was assessed with a modified selfreport procedure developed and validated by the Adult AIDS Clinical Trials Group (AACTG) (Chesney et al., 2000).”
MethodInfluential
Using Motivational Interviewing to Promote Adherence to Antiretroviral Medications: A Pilot Study
DiIorio, C. K., Resnicow, K., McDonnell, M., Soet, J. E., McCarty, F., & Yeager, K. A. (2003) · Journal of the Association of Nurses in AIDS Care · doi:10.1177/1055329002250996 · Cited by 129
Prevention for Substance-Using HIV-Positive Young People
Rotheram‐Borus, M. J., Swendeman, D. T., Comulada, W. S., Weiss, R. E., Lee, M., & Lightfoot, M. A. (2004) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/01.qai.0000140604.57478.67 · Cited by 129
“Used hard drugs§ 60% (34) 49% (30) 49% (27) 53% (91)”
Timing is everything: Antiretroviral nonadherence is associated with impairment in time-based prospective memory
Woods, S. P., Dawson, M., Weber, E., Gibson, S. A., Grant, I., & Atkinson, J. H. (2009) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617708090012 · Cited by 129
“Supporting the hypothesized role of cognitive defi cits in cART nonadherence, Chesney et al. ( 2000) found that nearly 70% of individuals who were nonadherent to cART reported that they “simply forgot” to take their medication.”
Background
The impact of methadone or buprenorphine treatment and ongoing injection on highly active antiretroviral therapy (HAART) adherence: evidence from the MANIF2000 cohort study
Roux, P., Carrieri, P., Villes, V., Dellamonica, P., Poizot‐Martin, I., Ravaux, I., & Spire, B. (2008) · Addiction · doi:10.1111/j.1360-0443.2008.02323.x · Cited by 129
Conscientiousness predicts disease progression (CD4 number and viral load) in people living with HIV.
O’Cleirigh, C. M., Ironson, G. H., Weiß, A., & Costa, P. T. (2007) · Health Psychology · doi:10.1037/0278-6133.26.4.473 · Cited by 128
Assessing Antiretroviral Adherence via Electronic Drug Monitoring and Self-Report: An Examination of Key Methodological Issues
Pearson, C., Simoni, J., Hoff, P. D., Kurth, A., & Martin, D. P. (2007) · Aids and Behavior · doi:10.1007/s10461-006-9133-3 · Cited by 145
“Previous studies have demonstrated that self-reported adherence is valid among individuals who report missing a dose ( Chesney, 1999; Kimmerling et al., 2003) and that acknowledgment of non-adherence can generally be believed (Liu et al., 2001).”
BackgroundInfluential
Consequences and Determinants of Adherence to Antiretroviral Medication: Results from Adult Aids Clinical Trials Group Protocol 370
Ickovics, J. R., Cameron, A. E., Zackin, R. A., Bassett, R. L., Chesney, M. A., Johnson, V. A., Kuritzkes, D. R., A Team, Acosta, E. P., Barnett, R. L., et al. (2002) · Antiviral Therapy · doi:10.1177/135965350200700308 · Cited by 128
“For each antiretroviral drug prescribed as part of the clinical trial, subjects reported the number of pills skipped on each of 4 days prior to each study visit [33].”
BackgroundSelf-citation
Stressful Life Events and Adherence in HIV
Leserman, J., Ironson, G. H., O’Cleirigh, C. M., Fordiani, J., & Balbin, E. (2008) · AIDS Patient Care and STDs · doi:10.1089/apc.2007.0175 · Cited by 127
“22 The following question in reference to their HIV treatment was asked, “When was the last time you missed any of your medications?””
Internalised HIV-stigma, loneliness, depressive symptoms and sleep quality in people living with HIV
Fekete, E. M., Williams, S. L., & Skinta, M. D. (2017) · Psychology and Health · doi:10.1080/08870446.2017.1357816 · Cited by 133
“HIV-related symptoms were assessed using the symptom items from the ACTG Adherence Baseline Questionnaire (Chesney et al., 2000).”
Method
HIV neuropathy in South Africans: Frequency, characteristics, and risk factors
Maritz, J., Benatar, M. G., Dave, J. A., Harrison, T. B., Badri, M., Levitt, N. S., & Heckmann, J. M. (2010) · Muscle & Nerve · doi:10.1002/mus.21535 · Cited by 130
Interpersonal Mechanisms Contributing to the Association Between HIV-Related Internalized Stigma and Medication Adherence
Helms, C. B., Turan, J. M., Atkins, G. C., Kempf, M.-C., Clay, O. J., Raper, J. L., Mugavero, M. J., & Turan, B. (2016) · AIDS and Behavior · doi:10.1007/s10461-016-1320-2 · Cited by 126
The Information–Motivation–Behavioral Skills Model of ART Adherence in a Deep South HIV+ Clinic Sample
Amico, K. R., Barta, W. D., Konkle‐Parker, D. J., Fisher, J. D., Cornman, D. H., Shuper, P. A., & Fisher, W. A. (2007) · AIDS and Behavior · doi:10.1007/s10461-007-9311-y · Cited by 126
A Randomized Controlled Trial to Enhance Antiretroviral Therapy Adherence in Patients with a History of Alcohol Problems
Samet, J. H., Horton, N. J., Meli, S. M., Dukes, K., Tripp, T. J., SULLIVAN, L. M., & Freedberg, K. A. (2005) · Antiviral Therapy · doi:10.1177/135965350501000106 · Cited by 125
“Both 3-day and 30-day self-reported adherence were measured using the AIDS Clinical Trials Group (ACTG) scale [29].”
Method
Mental Health Treatment to Reduce HIV Transmission Risk Behavior: A Positive Prevention Model
Sikkema, K. J., Watt, M. H., Drabkin, A. S., Meade, C. S., Hansen, N. B., & Pence, B. W. (2009) · AIDS and Behavior · doi:10.1007/s10461-009-9650-y · Cited by 124
“Adherence to care and treatment remains a challenge for many HIV infected patients [9, 21, 22] and deserves attention in secondary HIV prevention efforts.”
Reductions in depressed mood and denial coping during cognitive behavioral stress management with hiv-positive gay men treated with haart
Carrico, A. W., Antoni, M. H., Durán, R. E., Ironson, G. H., Penedo, F. J., FLETCHER, M. A., Klimas, N. G., & Schneiderman, N. (2006) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm3102_7 · Cited by 130
“As a result, a number of psychosocial variables have been related to nonadherence to HAART, including elevated alcohol consumption ( 6 ), lack of perceived social support (7), depressed mood and poor emotional functioning (8), avoid-”
BackgroundMethod
Personality, quality of life and HAART adherence among men and women living with HIV/AIDS
Penedo, F. J., Gonzalez, J. S., Dahn, J. R., Antoni, M., Malow, R. M., Costa, P. T., & Schneiderman, N. (2003) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00482-8 · Cited by 123
“Although the ACTG [6] is the most widely used self-reported adherence measure in HIV/ AIDS, this measure only captures HAART adherence over a 4-day period.”
BackgroundMethod
How Does Depression Influence Diabetes Medication Adherence in Older Patients?
Kilbourne, A. M., Reynolds, C. F., Good, C. B., Sereika, S. M., Justice, A. C., & Fine, M. J. (2005) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200503000-00005 · Cited by 124
Overload: Impact of Incident Stressful Events on Antiretroviral Medication Adherence and Virologic Failure in a Longitudinal, Multisite Human Immunodeficiency Virus Cohort Study
Mugavero, M. J., Raper, J. L., Reif, S., Whetten, K., Leserman, J., Thielman, N. M., & Pence, B. W. (2009) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181bfe8d2 · Cited by 122
Health literacy, antiretroviral adherence, and HIV-RNA suppression
Paasche-Orlow, M., Cheng, D., Palepu, A., Meli, S., Faber, V., & Samet, J. (2007) · Journal of general internal medicine · doi:10.1111/j.1525-1497.2006.00527.x · Cited by 58
Factors Related to Adherence to Statin Therapy
McGinnis, B., Olson, K. L., Magid, D. J., Bayliss, E., Korner, E. J., Brand, D. W., & Steiner, J. F. (2007) · Annals of Pharmacotherapy · doi:10.1345/aph.1k209 · Cited by 121
A Programmable Prompting Device Improves Adherence to Highly Active Antiretroviral Therapy in HIV-Infected Subjects with Memory Impairment
Andrade, A. S., McGruder, H. F., Wu, A. W., Celano, S. A., Skolasky, R. L., Selnes, O. A., Huang, I., & McArthur, J. C. (2005) · Clinical Infectious Diseases · doi:10.1086/432877 · Cited by 121
“We used the AIDS Clinical Trial Group (ACTG) Adherence Questionnaire as a secondary measurement of adherence [10].”
MethodSelf-citation
Primary Care Provider Cultural Competence and Racial Disparities in HIV Care and Outcomes
Saha, S. S., Korthuis, P. T., Cohn, J. A., Sharp, V., Moore, R. D., & Beach, M. C. (2013) · Journal of General Internal Medicine · doi:10.1007/s11606-012-2298-8 · Cited by 120
Determinants of non-adherence to subsidized anti-retroviral treatment in southeast Nigeria
Uzochukwu, B. S. C., Onwujekwe, O. E., Onoka, A. C., Okoli, C. I., Uguru, N. P., & Chukwuogo, O. (2009) · Health Policy and Planning · doi:10.1093/heapol/czp006 · Cited by 119
“Chesney et al. (2000) found that 24% of patients cited the wish to avoid side effects as a reason for failing to take their medication as prescribed.”
Background
Understanding Racial Disparities in HIV Using Data From the Veterans Aging Cohort 3-Site Study and VA Administrative Data
McGinnis, K. A., Fine, M. J., Sharma, R. K., Skanderson, M., Wagner, J. H., Rodriguez‐Barradas, M. C., Rabeneck, L., & Justice, A. C. (2003) · American Journal of Public Health · doi:10.2105/ajph.93.10.1728 · Cited by 119
Predictors of medication adherence among HIV-infected youth
Hosek, S., Harper, G. W., & Domanico, R. (2005) · Psychology Health & Medicine · doi:10.1080/1354350042000326584 · Cited by 118
“The results from this study support the existing literature by demonstrating that rates of adherence to HIV medications are poor in adolescent populations (Chesney et al., 2000; Malow et al., 1998; Muma et al., 1995; Murphy et al., 2001).”
Result
Diagnosing Symptomatic HIV-Associated Neurocognitive Disorders: Self-Report Versus Performance-Based Assessment of Everyday Functioning
Blackstone, K., Moore, D. J., Heaton, R. K., Franklin, D. R., Woods, S. P., Clifford, D. B., Collier, A. C., Marra, C. M., Gelman, B. B., McArthur, J. C., et al. (2011) · Journal of the International Neuropsychological Society · doi:10.1017/s135561771100141x · Cited by 117
“However, self-report is susceptible to social desirability and recall inaccuracies or bias, which may overestimate ability (Chesney et al., 2000; Thames, Kim, et al., 2010).”
Background
Randomized Study of the Safety and Efficacy of Fish Oil (Omega-3 Fatty Acid) Supplementation with Dietary and Exercise Counseling for the Treatment of Antiretroviral Therapy--Associated Hypertriglyceridemia
Wohl, D. A., Tien, H.-C., Busby, M. G., Cunningham, C., MacIntosh, B., Napravnik, S., Danan, E. R., Donovan, K., Hossenipour, M., & Simpson, R. J. (2005) · Clinical Infectious Diseases · doi:10.1086/497273 · Cited by 118
A Marginal Structural Model to Estimate the Causal Effect of Antidepressant Medication Treatment on Viral Suppression Among Homeless and Marginally Housed Persons With HIV
Tsai, A. C., Weiser, S. D., Petersen, M. L., Ragland, K. E., Kushel, M., & Bangsberg, D. R. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.160 · Cited by 119
Measurement Properties of Existing Patient-Reported Outcome Measures on Medication Adherence: Systematic Review
Kwan, Y. H., Weng, S. D., Loh, D. H. F., Phang, J. K., Oo, L. J. Y., Blalock, D. V., Chew, E., Yap, K. Z., Tan, C. Y. K., Yoon, S., et al. (2020) · Journal of Medical Internet Research · doi:10.2196/19179 · Cited by 126
Sexual and drug risk-related behaviours after initiating highly active antiretroviral therapy among injection drug users
Vlahov, D., Safaien, M., Lai, S., Strathdee, S. A., Johnson, L., Sterling, T. R., & Celentano, D. D. (2001) · AIDS · doi:10.1097/00002030-200111230-00013 · Cited by 115
“Certainly, other studies have suggested that using pill counts or MEMS caps (computer chips in medication bottle caps that identify when bottles are opened) show that adherence to antiretroviral medications are less than what is self reported [20]; J Arnsten”
Background
Retention in Opioid Substitution Treatment: A Major Predictor of Long‐Term Virological Success for HIV‐Infected Injection Drug Users Receiving Antiretroviral Treatment
Roux, P., Carrieri, P., Cohen, J., Ravaux, I., Poizot‐Martin, I., Dellamonica, P., & Spire, B. (2009) · Clinical Infectious Diseases · doi:10.1086/630209 · Cited by 115
“Information about adherence to HAART was obtained from the selfadministered questionnaires and the face-to-face interviews, in accordance with the methods of the Adult AIDS Clinical Trial Group [12].”
Method
Barriers to HIV Care and Treatment Among Participants in a Public Health HIV Care Relinkage Program
Dombrowski, J. C., Simoni, J. M., Katz, D. A., & Golden, M. R. (2015) · AIDS Patient Care and STDs · doi:10.1089/apc.2014.0346 · Cited by 115
“19 We asked participants about barriers to care as follows: ‘‘Below are several reasons why people sometimes don’t have HIV doctors or don’t see them as often as they might.”
Case Management Is Associated with Improved Antiretroviral Adherence and CD4+Cell Counts in Homeless and Marginally Housed Individuals with HIV Infection
Kushel, M., Colfax, G. N., Ragland, K. E., Heineman, A., Palacio, H., & Bangsberg, D. R. (2006) · Clinical Infectious Diseases · doi:10.1086/505212 · Cited by 115
“We measured adherence using a standard 3-day structured interview [21].”
Method
Response to Antiretroviral Therapy in HIV-Infected Patients Attending a Public, Urban Clinic in Kampala, Uganda
Spacek, L. A., Shihab, H. M., Kamya, M. R., Mwesigire, D. M., Ronald, A., Mayanja‐Kizza, H., Moore, R. D., Bates, M. P., & Quinn, T. C. (2005) · Clinical Infectious Diseases · doi:10.1086/499044 · Cited by 115
Contraceptive Efficacy of Oral and Transdermal Hormones When Co-Administered With Protease Inhibitors in HIV-1-Infected Women: Pharmacokinetic Results of ACTG Trial A5188
Vogler, M. A., Patterson, K. B., Kamemoto, L. E., Park, J., Watts, H. D., Aweeka, F. T., Klingman, K. L., & Cohn, S. E. (2010) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e3181eb5ff5 · Cited by 115
“Adherence to ARV medication was assessed over the prior 4 days at each study visit using a self-report questionnaire developed by the AIDS Clinical Trials Group.(13) The study was projected to enroll 27 evaluable subjects in both the LPV/r-based arm and the control arm for a total of 54 evaluable subjects, to provide…”
MethodInfluential
Feasibility and Acceptability of a Task-Shifted Intervention to Enhance Adherence to HIV Medication and Improve Depression in People Living with HIV in Zimbabwe, a Low Income Country in Sub-Saharan Africa
Abas, M., Nyamayaro, P. C., Bere, T. C., Saruchera, E., Mothobi, N. Z., Simms, V. M., Mangezi, W. O., Macpherson, K., Croome, N., Magidson, J. F., et al. (2017) · AIDS and Behavior · doi:10.1007/s10461-016-1659-4 · Cited by 116
“and duration of treatment, AUDIT-C screening for alcohol misuse, and self-reported adherence [40].”
Method
Use of an on-line pager system to increase adherence to antiretroviral medications
Safren, S. A., Hendriksen, E. S., Desousa, N., Boswell, S. L., & Mayer, K. H. (2003) · AIDS Care · doi:10.1080/09540120310001618630 · Cited by 110
“For example, in AACTG trials, ‘‘forgetting’’ was reported as the most frequent reason for non-adherence (Chesney et al. , 2000).”
Background
Efficacy and safety of efavirenz 400 mg daily versus 600 mg daily: 96-week data from the randomised, double-blind, placebo-controlled, non-inferiority ENCORE1 study
Carey, D., Puls, R. L., Amin, J., Losso, M. H., Phanupak, P., Foulkes, S., Mohapi, L., Crabtree‐Ramírez, B., Jessen, H. K., Kumar, S., et al. (2015) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(15)70060-5 · Cited by 113
Adherence to antiretroviral therapy in rural persons living with HIV disease in the United States
Heckman, B. D., Catz, S. L., Heckman, T. G., Miller, J. G., & Kalichman, S. C. (2003) · AIDS Care · doi:10.1080/09540120410001641066 · Cited by 113
Mindfulness-Based Stress Reduction for HIV Treatment Side Effects: A Randomized, Wait-List Controlled Trial
Duncan, L. G., Moskowitz, J. T., Neilands, T. B., Dilworth, S. E., Hecht, F. M., & Johnson, M. O. (2011) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2011.04.007 · Cited by 114
Examining the relationship between psychological distress and adherence to anti-retroviral therapy among Ugandan adolescents living with HIV
Mutumba, M., Musiime, V., Lepkwoski, J. M., Harper, G. W., SNOW, R. C., Resnicow, K., & Bauermeister, J. A. (2016) · AIDS Care · doi:10.1080/09540121.2015.1131966 · Cited by 110
“The primary outcome in this study was adherence, assessed as three binary indicators described below: Non-adherence was assessed using the self-report AACTG Adherence Scale (Chesney et al., 2000) from which three indicators computed.”
Method
Factors Associated With Nonadherence to Highly Active Antiretroviral Therapy
Carrieri, P., Leport, C., Protopopescu, C., Cassuto, J., Bouvet, É., Peyramond, D., Raffi, F., Moatti, J., Cheê, G., & Spire, B. (2006) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/01.qai.0000186364.27587.0e · Cited by 108
“Five questions about adherence to HAART were included in all self-administered questionnaires, in accordance with the methodology established by the AIDS Clinical Trial Group.16 Adherence at each assessment was classified in one of 3 categories: high, moderate, or poor.6 Patients were first asked to list each drug inc…”
Method
Primary Relationships, HIV Treatment Adherence, and Virologic Control
Johnson, M. O., Dilworth, S., Taylor, J. M., Darbes, L., Comfort, M. L., & Neilands, T. (2012) · Aids and Behavior · doi:10.1007/s10461-011-0021-0 · Cited by 112
“First, the adherence measure developed to assess adherence in the AIDS Clinical Trials Group (ACTG) [55] provides detailed information about adherence over the prior 3 days.”
Relationship Between Spiritual Coping and Survival in Patients with HIV
Ironson, G. H., Kremer, H., & Lucette, A. (2016) · Journal of General Internal Medicine · doi:10.1007/s11606-016-3668-4 · Cited by 114
Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model
DiIorio, C. K., McCarty, F., DePadilla, L. M., Resnicow, K., Holstad, M. M., Yeager, K. A., Sharma, S. M., Morisky, D. E., & Lundberg, B. E. (2007) · AIDS and Behavior · doi:10.1007/s10461-007-9318-4 · Cited by 107
“Adherence was measured using 14 self report items from The UCSF Adherence Questionnaire (Chesney et al. 2000) that describe reasons for missing medication during the past 30 days.”
Method
Evaluation of the Patient Medication Adherence Questionnaire As a Tool for Self-Reported Adherence Assessment in HIV-Infected Patients on Antiretroviral Regimens
Duong, M., Piroth, L., Grappin, M., Forte, F., Peytavin, G., Buisson, M., Chavanet, P., & Portier, H. (2001) · HIV Clinical Trials · doi:10.1310/m3jr-g390-lxcm-f62g · Cited by 109

Authors: Chesney, M. A., Ickovics, J. R., Chambers, D. B., Gifford, A. L., Neidig, J., Zwickl, B., Wu, A. W., & PATIENT CARE COMMITTEE & ADHERENCE
Affiliations: University of California, San Francisco (US)
Yale University (US)
University of California San Diego (US)
The Ohio State University (US)
Indiana University Indianapolis (US)
Johns Hopkins University (US)
ORCID: Chesney, M. A.
Ickovics, J. R.
Gifford, A. L.
Wu, A. W.
Venue: AIDS Care
Publisher: Informa UK Limited
Published: 2000-06
Volume: 12
Issue: 3
Pages: 255-266
ISSN: 0954-0121 (ISSN-L)
1360-0451
DOI: 10.1080/09540120050042891
OpenAlex: W2088423598
Cited by: 1,428
References: 12
Citations by year: 2026: 14 · 2025: 28 · 2024: 29 · 2023: 29 · 2022: 40 · 2021: 53 · 2020: 51 · 2019: 55 · 2018: 61 · 2017: 66 · 2016: 67 · 2015: 76 · 2014: 81 · 2013: 84 · 2012: 74
FWCI: 27.22
Type: journal article
Language: en
Open access: closed
Locations: AIDS Care (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (P50-MH42459, P30MH059037, P50MH042459, P30-MH 59037)
National Institute of Allergy and Infectious Diseases (U01AI-38858, U01AI038858)
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
Keywords: antiretroviral therapy adherence, HIV, self-report questionnaire, medication non-adherence, adherence self-efficacy, alcohol consumption, protease inhibitors, clinical trial participants, questionnaire development
MeSH terms: Adult, Alcohol Drinking, Clinical Trials as Topic, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Patient Compliance, Pilot Projects, Surveys and Questionnaires, Risk Factors, Socioeconomic Factors, HIV Infections, Anti-HIV Agents, Substance-Related Disorders

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Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The AACTG Adherence Instruments

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