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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Beliefs about antiretroviral therapy, treatment adherence and quality of life in a 48-week randomised study of continuation of zidovudine/lamivudine or switch to tenofovir DF/emtricitabine, each with efavirenz
Cooper, V., Moyle, G. J., Fisher, M., Reilly, G., Ewan, J., Liu, H. C., Horne, R., & With, F. T. S. S. (2011) · AIDS Care · doi:10.1080/09540121.2010.534433 · Cited by 45
“A range of perceptual barriers to ART adherence have been identified, (Chesney et al., 2000; Gifford et al., 2000; Molassiotis et al., 2002; Spire, Duran, Souville, Leport C, & Raffi, 2002).”
Background
Efficacy of a lay health worker led group antiretroviral medication adherence training among non-adherent HIV-positive patients in KwaZulu-Natal, South Africa: Results from a randomized trial
Peltzer, K., Ramlagan, S., Jones, D. L., Weiss, S. M., Fomundam, H., & Chanetsa, L. (2012) · SAHARA-J Journal of Social Aspects of HIV/AIDS · doi:10.1080/17290376.2012.745640 · Cited by 45
“Self-reported adherence (4-day recall and weekend) was assessed three times (at baseline, postintervention, and 6 months follow-up) and was dichotomized into those having missed or not having missed doses in the past 4 days and/or weekend (Chesney et al. 2000).”
Method
Language, Literacy, and Communication Regarding Medication in an Anticoagulation Clinic: A Comparison of Verbal vs. Visual Assessment
Schillinger, D., Machtinger, E. L., Wang, F. M., Palácios, J., Rodriguez, M., & Bindman, A. B. (2006) · Journal of Health Communication · doi:10.1080/10810730600934500 · Cited by 45
“Research assistants asked subjects to report their 7-day warfarin adherence using a validated instrument (Chesney et al., 2000; Golin et al., 2002) that asks patients to recall the number of days in the past week they missed taking their medication.”
Method
Depression and symptomatic response among HIV-infected drug users enrolled in a randomized controlled trial of directly administered antiretroviral therapy
Springer, S. A., Chen, S., & Altice, F. L. (2009) · AIDS Care · doi:10.1080/09540120802657555 · Cited by 45
“…depression) (Radloff, 1977), self-efficacy scale (Huba & Melchior), Drug Abuse Symptoms Test (DAST-10 for addiction severity) (Skinner, 1982), and AIDS Clinical Trial Group (ACTG) three-day recall for adherence (Chesney et al., 2000) that were also assessed at baseline, one, three, and six months.”
Abriendo Puertas: Feasibility and Effectiveness a Multi-Level Intervention to Improve HIV Outcomes Among Female Sex Workers Living with HIV in the Dominican Republic
Kerrigan, D. L., Barrington, C., Donastorg, Y., Pérez, M., & Galai, N. (2016) · AIDS and Behavior · doi:10.1007/s10461-016-1376-z · Cited by 44
Psychiatric Disorders, Antiretroviral Medication Adherence and Viremia in a Cohort of Perinatally HIV-Infected Adolescents and Young Adults
Bucek, A., Leu, C., Benson, S. M., Warne, P. A., Abrams, E. J., Elkington, K. S., Dolezal, C. L., WIZNIA, A. A., & Mellins, C. A. (2017) · The Pediatric Infectious Disease Journal · doi:10.1097/inf.0000000000001866 · Cited by 45
Predictors of non-adherence to antiretroviral therapy among HIV infected patients in northern Tanzania
Semvua, S. K., Orrell, C., Mmbaga, B. T., Semvua, H. H., Bartlett, J. A., & Boulle, A. (2017) · PLoS ONE · doi:10.1371/journal.pone.0189460 · Cited by 45
Adherence counseling practices of generalist and specialist physicians caring for people living with HIV/AIDS in North Carolina
Golin, C., Smith, S. R., & Reif, S. (2007) · Journal of general internal medicine · doi:10.1111/j.1525-1497.2004.21151.x · Cited by 47
Test of a Web-Based Program to Improve Adherence to HIV Medications
Hersch, R. K., Cook, R. F., Billings, D. W., Kaplan, S. A., Murray, D. M., Safren, S. A., Goforth, J., & Spencer, J. (2013) · AIDS and Behavior · doi:10.1007/s10461-013-0535-8 · Cited by 44
“Self-Reported Adherence Self-reported adherence was measured using the AIDS Clinical Trials Group (ACTG) Adherence Measure [22].”
Method
The Validity of Self-Reported Medication Adherence as an Outcome in Clinical Trials of Adherence-Promotion Interventions: Findings from the MACH14 Study
Simoni, J. M., Huh, D., Wang, Y., Wilson, I. B., Reynolds, N. R., Remien, R. H., Goggin, K., Gross, R., Rosen, M. I., Schneiderman, N., et al. (2014) · AIDS and Behavior · doi:10.1007/s10461-014-0905-x · Cited by 44
Prior Illicit Drug Use and Missed Prenatal Vitamins Predict Nonadherence to Antiretroviral Therapy in Pregnancy: Adherence Analysis A5084
Cohn, S. E., Umbleja, T., Mrus, J. M., Bardeguez, A. D., Andersen, J. W., & Chesney, M. A. (2007) · AIDS Patient Care and STDs · doi:10.1089/apc.2007.0053 · Cited by 44
Self-citation
The Interplay of Sociodemographic Factors on Virologic Suppression Among a U.S. Outpatient HIV Clinic Population
Shacham, E., Nurutdinova, D., Önen, N. F., Stamm, K., & Overton, E. T. (2010) · AIDS Patient Care and STDs · doi:10.1089/apc.2009.0275 · Cited by 44
Psychosocial Impact of Poverty on Antiretroviral Nonadherence Among HIV-TB Coinfected Patients in Lima, Peru
Shin, S. S., Muñoz, M., Espiritu, B., Zeladita-Huamán, J. A., Sánchez, E., Callacna, M., Rojas, C., Arévalo, J., Wu, Y., Caldas, A., et al. (2008) · Journal of the International Association of Physicians in AIDS Care · doi:10.1177/1545109708315326 · Cited by 44
“In the Unites States, low social support, depression, substance use, and lower socioeconomic level have all been associated with HAART nonadherence, in particular, among poor populations.(17-21) Data supporting the impact of psychosocial factors on HAART adherence in resource-poor settings are scarce.”
Background
The Malaysian Medication Adherence Scale (MALMAS): Concurrent Validity Using a Clinical Measure among People with Type 2 Diabetes in Malaysia
Chung, W. W., Chua, S. S., Lai, P. S. M., & Morisky, D. E. (2015) · PLoS ONE · doi:10.1371/journal.pone.0124275 · Cited by 44
“0) [1–43] (13.”
Background
Recent drug use, homelessness and increased short-term mortality in HIV-infected persons with alcohol problems
Walley, A. Y., Cheng, D. M., Libman, H., Nunes, D., Horsburgh, C. R., Saitz, R., & Samet, J. H. (2008) · AIDS · doi:10.1097/qad.0b013e3282f423f8 · Cited by 44
Side effects, adherence self-efficacy, and adherence to antiretroviral treatment: a mediation analysis in a Chinese sample
Zhang, L., Li, X., Lin, Z., Jacques‐Tiura, A. J., Xu, J., Zhou, Y., Qiao, S., Shen, Z., & STANTON, B. F. (2016) · AIDS Care · doi:10.1080/09540121.2015.1124984 · Cited by 44
“conducted for the last two decades (Chesney et al., 2000); however, we are not aware of any previous studies in this field among PLHIV in China.”
Background
Reasons for Missing Antiretroviral Therapy: Results from a Multi-Country Study in Tanzania, Uganda, and Zambia
Koole, O., Denison, J., Menten, J., Tsui, S., Wabwire-mangen, F., Kwesigabo, G., Mulenga, M., Auld, A., Agolory, S., Mukadi, Y., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0147309 · Cited by 45
Positive Strategies to Enhance Problem-Solving Skills (STEPS): A Pilot Randomized, Controlled Trial of a Multicomponent, Technology-Enhanced, Customizable Antiretroviral Adherence Intervention for HIV-Infected Adolescents and Young Adults
Mimiaga, M. J., Bogart, L. M., Thurston, I. B., Santostefano, C. M., Closson, E. F., Skeer, M. R., Biello, K. B., & Safren, S. A. (2019) · AIDS Patient Care and STDs · doi:10.1089/apc.2018.0138 · Cited by 44
Development and evaluation of a clinical algorithm to monitor patients on antiretrovirals in resource-limited settings using adherence, clinical and CD4 cell count criteria
Meya, D. B., Spacek, L. A., Tibenderana, H., John, L., Namugga, I., Magero, S., Dewar, R. L., Quinn, T. C., Colebunders, R., Kambugu, A. D., et al. (2009) · Journal of the International AIDS Society · doi:10.1186/1758-2652-12-3 · Cited by 44
Pediatric HIV medication adherence
Brackis‐Cott, E., Mellins, C. A., Abrams, E. J., Reval, T., & Dolezal, C. L. (2003) · Journal of Pediatric Health Care · doi:10.1016/s0891-5245(02)88313-4 · Cited by 44
Estudios de adherencia a los fármacos antirretrovirales. Una revisión sistemática
Puigventós, F., Riera, M., Delibes, C., Peñaranda, M., de la Fuente, L., & Boronat, A. (2002) · Medicina Clínica · doi:10.1016/s0025-7753(02)73341-1 · Cited by 44
Editorial Commentary:Adherence to Antiretroviral Therapy: How Much Is Enough?
Gulick, R. M. (2006) · Clinical Infectious Diseases · doi:10.1086/507549 · Cited by 44
“Maggiolo et al. [ 10 ] assessed adherence with the AIDS Clinical Trial Group adherence questionnaire, administered to 543 patients who were taking first-, second-, or third-line antiretroviral regimens that consisted of PI- (primarily indinavir and nelfinavir), NNRTI-, or triple-nucleoside‐based treatment and in whom…”
BackgroundMethodInfluential
Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes – a randomised controlled trial protocol
Parry, C. D., Morojele, N. K., Myers, B. J., Kekwaletswe, C. T., Manda, S. O., Sorsdahl, K., Ramjee, G., Hahn, J. A., Rehm, J., & Shuper, P. A. (2014) · BMC Infectious Diseases · doi:10.1186/1471-2334-14-500 · Cited by 43
The use of nationwide on‐line prescription records improves the drug history in hospitalized patients
Glintborg, B., Poulsen, H. E., & Dalhoff, K. (2007) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.2007.03017.x · Cited by 43
Raltegravir Non-Inferior to Nucleoside Based Regimens in SECOND-LINE Therapy with Lopinavir/Ritonavir over 96 Weeks: A Randomised Open Label Study for the Treatment Of HIV-1 Infection
Amin, J., Boyd, M. A., Kumarasamy, N., Moore, C. L., Losso, M. H., Nwizu, C. A., Mohapi, L., Kerr, S. J., Sohn, A. H., Teppler, H., et al. (2015) · PLoS ONE · doi:10.1371/journal.pone.0118228 · Cited by 43
“Adherence was measured at Weeks 4, 48 and 96 using the Adult AIDS Clinical Trials Group adherence instrument [6].”
Method
Enhancing the health of women living with HIV: the SMART/EST Women's Project
Weiss, S. M. (2011) · International Journal of Women s Health · doi:10.2147/ijwh.s5947 · Cited by 45
Comparing Self-Report Pre-Exposure Prophylaxis Adherence Questions to Pharmacologic Measures of Recent and Cumulative Pre-Exposure Prophylaxis Exposure
Blumenthal, J. S., Pasipanodya, E. C., Jain, S., Sun, S., Ellorin, E. E., Morris, S., & Moore, D. J. (2019) · Frontiers in Pharmacology · doi:10.3389/fphar.2019.00721 · Cited by 42
Adherence to Antiretroviral Therapy and Associated Factors among People Living with HIV/AIDS in Hara Town and Its Surroundings, North-Eastern Ethiopia: A Cross-Sectional Study
Legesse, T. A., & Reta, M. A. (1970) · Ethiopian Journal of Health Sciences · doi:10.4314/ejhs.v29i3.2 · Cited by 43
“We adapted the questionnaire partly from the AIDS Clinical Trial Group (ACTG) (23), adherence baseline and follow-up questionnaires.”
Method
Drug resistance and adherence to HIV/AIDS antiretroviral treatment
Moatti, J., Spire, B., & Kazatchkine, M. D. (2004) · AIDS · doi:10.1097/00002030-200406003-00011 · Cited by 43
“In practice, although self-report may underestimate non-adherence, especially when data collection is directly part of the patient/medical staff relationship, patients’ reports through validated self-administered questionnaires or face-to-face interviews [54] can be used for operational monitoring and”
BackgroundMethod
Reasons for ART non-adherence in the Deep South: Adherence needs of a sample of HIV-positive patients in Mississippi
Amico, K. R., Konkle‐Parker, D. J., Cornman, D. H., Barta, W. D., Ferrer, R. A., Norton, W. E., Trayling, C., Shuper, P. A., Fisher, J. D., & Fisher, W. A. (2007) · AIDS Care · doi:10.1080/09540120701426516 · Cited by 44
“Chesney et al, 2000 ; Murphy et al, 2000 , 2004 ; Oggins, 2003 ; Roberts & Mann, 2000 ) and New York (Berg et al, 2004 ; Oggins, 2003 ).”
‘Simply forgot’ is the most frequently stated reason for missed doses of HAART irrespective of degree of adherence
Barfod, T., Sørensen, H., Nielsen, H., Rodkjær, L., & Obel, N. (2006) · HIV Medicine · doi:10.1111/j.1468-1293.2006.00387.x · Cited by 59
A longitudinal investigation of the impact of life stress on HIV treatment adherence
Bottonari, K. A., Safren, S. A., McQuaid, J. R., Hsiao, C. B., & Roberts, J. E. (2010) · Journal of Behavioral Medicine · doi:10.1007/s10865-010-9273-9 · Cited by 42
“Moreover, depression has also been associated with poor HIV treatment adherence (Ammassari et al. 2004; Gonzalez et al. 2004; Lima et al. 2007; Safren et al. 2001), though there have been some mixed findings ( Catz et al. 2000; Deschamps et al. 2004; Komiti et al. 2003).”
Result
Antiretroviral treatment and quality of life in Africans living with HIV: 12‐month follow‐up in Burkina Faso
Jaquet, A., Garanet, F., Balestre, É., Ekouévi, D. K., Azani, J.-C., Bognounou, R., Dah, E. T. T., Kondombo, J. C., Dabis, F., & Drabo, J. Y. (2013) · Journal of the International AIDS Society · doi:10.7448/ias.16.1.18867 · Cited by 42
Adherence to antiretroviral medication in older adults living with HIV/AIDS: a comparison of alternative models
Johnson, C. J., Heckman, T. G., Hansen, N. B., Kochman, A., & Sikkema, K. J. (2009) · AIDS Care · doi:10.1080/09540120802385611 · Cited by 42
“Adherence was assessed via items adapted from the ACTG adherence questionnaire (Chesney et al., 2000).”
Method
The relationship between stress and clinical outcomes for persons living with HIV/AIDS: a systematic review of the global literature
Weinstein, T. L., & Li, X. (2015) · AIDS Care · doi:10.1080/09540121.2015.1090532 · Cited by 44
Adolescent human immunodeficiency virus self-management: Associations with treatment adherence, viral suppression, sexual risk behaviours and health-related quality of life
Crowley, T., van der Merwe, A., Kidd, M., & Skinner, D. G. (2020) · Southern African Journal of HIV Medicine · doi:10.4102/sajhivmed.v21i1.1054 · Cited by 42
Computer-Assisted Self-Interviewing (CASI) to Improve Provider Assessment of Adherence in Routine Clinical Practice
Bangsberg, D. R., Bronstone, A. B., Chesney, M. A., & Hecht, F. M. (2002) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-200212153-00004 · Cited by 42
Self-citation
Development and Validation of the HIV Medication Readiness Scale
Balfour, L., Tasca, G. A., Kowal, J., Corace, K. M., Cooper, C., Angel, J. B., Garber, G. E., MacPherson, P. A., & Cameron, D. W. (2007) · Assessment · doi:10.1177/1073191107304295 · Cited by 41
“The first self-report measure of adherence was adapted from the validated Adult AIDS Clinical Trials Group (AACTG) adherence instrument (Chesney et al., 2000).”
BackgroundMethod
Active cocaine use is associated with lack of HIV-1 virologic suppression independent of nonadherence to antiretroviral therapy: Use of a rapid screening tool during routine clinic visits
Rasbach, D. A., Desruisseau, A. J., Kipp, A. M., Stinnette, S. E., Kheshti, A., Shepherd, B. E., Sterling, T. R., Hulgan, T., McGowan, C. C., & Qian, H. (2012) · AIDS Care · doi:10.1080/09540121.2012.687814 · Cited by 42
“ART adherence and drug use data were collected by CCC medical providers using a brief questionnaire (Table 1) modified from previously validated questionnaires (Chesney et al., 2000; Toobert, Hampson, & Glasgow, 2000).”
Method
HIV-infected pregnant women and vertical transmission in Europe since 1986. European collaborative study.
Thorne, C., Newell, M., & Gray, L. (2001) · PubMed · Cited by 42
Which adherence measure – self‐report, clinician recorded or pharmacy refill – is best able to predict detectable viral load in a public ART programme without routine plasma viral load monitoring?
Mekuria, L. A., Prins, J. M., Yalew, A. W., Sprangers, M. A. G., & Nieuwkerk, P. T. (2016) · Tropical Medicine & International Health · doi:10.1111/tmi.12709 · Cited by 41
HIV-related stigmatization and medication adherence: Indirect effects of disclosure concerns and depression.
Mitzel, L. D., Vanable, P. A., & Carey, M. P. (2018) · Stigma and Health · doi:10.1037/sah0000144 · Cited by 41
“HIV medication adherence—Participants reported their HIV medication-taking behaviors on a measure adapted from previous work (Catz, Kelly, Bogart, Benotsch, & McAuliffe, 2000; Chesney et al., 2000).”
Method
Lopinavir/ritonavir monotherapy after virologic failure of first-line antiretroviral therapy in resource-limited settings
Bartlett, J. A., Ribaudo, H. J., Wallis, C. L., Aga, E., Katzenstein, D. A., Stevens, W. S., Norton, M. R., Klingman, K. L., Hosseinipour, M. C., Crump, J. A., et al. (2012) · AIDS · doi:10.1097/qad.0b013e328353b066 · Cited by 41
“At every study visit, a clinical assessment, list of concomitant medications, adherence interview using the ACTG Adherence Questionnaire [10] and pill count were performed.”
Method
Social factors affecting ART adherence in rural settings in Zambia
Nozaki, I., Dube, C., Kakimoto, K., Yamada, N., & Simpungwe, J. (2011) · AIDS Care · doi:10.1080/09540121.2010.542121 · Cited by 41
“Keywords: antiretroviral therapy; adherence; rural setting”
Influential
Gender Differences in HIV-Related Coping and Depression
Vosvick, M. A., Martin, L. A., Smith, N. G., & Jenkins, S. R. (2008) · AIDS and Behavior · doi:10.1007/s10461-008-9490-1 · Cited by 45
Intentionality of medication non-adherence among individuals living with HIV/AIDS in Hong Kong
Mo, P. K. H., & Mak, W. W. S. (2009) · AIDS Care · doi:10.1080/09540120802511968 · Cited by 41
“Adherence self-efficacy Adherence self-efficacy was measured by a single item from the AIDS Clinical Trial Group (ACTG) adherence measure (Chesney et al., 2000).”
BackgroundMethodResultInfluential
Motivational groups support adherence to antiretroviral therapy and use of risk reduction behaviors in HIV positive Nigerian women: a pilot study.
Holstad, M. M., Essien, J. E., Ekong, E., Higgins, M. K., Teplinskiy, I., & Adewuyi, M. F. (2012) · African Journal of Reproductive Health · Cited by 41
Health Literacy and Demographic Disparities in HIV Care Continuum Outcomes
Rebeiro, P. F., McPherson, T. D., Goggins, K. M., Turner, M. M., Bebawy, S. S., Rogers, W. B., Brinkley‐Rubinstein, L., Person, A. K., Sterling, T. R., Kripalani, S. B., et al. (2018) · AIDS and Behavior · doi:10.1007/s10461-018-2092-7 · Cited by 43
“Antiretroviral adherence was measured using a brief questionnaire [35] modified from previously validated questionnaires [36, 37].”
Method
Self-efficacy and depression as mediators of the relationship between pain and antiretroviral adherence
Berg, K. M., Cooperman, N. A., Newville, H., & Arnsten, J. H. (2009) · AIDS Care · doi:10.1080/09540120802001697 · Cited by 41
“The main outcome was self-reported antiretroviral adherence, which we assessed using questions from the AIDS Clinical Trials Group (ACTG) questionnaire (Chesney et al., 2000) and operationalized as [(number of pills taken)/(number of pills prescribed)] 100 during the prior seven days.”
Antiretroviral Medication Diversion Among HIV-Positive Substance Abusers in South Florida
Surratt, H. L., Kurtz, S. P., Cicero, T. J., O’Grady, C. L., & Levi‐Minzi, M. A. (2013) · American Journal of Public Health · doi:10.2105/ajph.2012.301092 · Cited by 42
The impact of neurobehavioral features on medication adherence in HIV: Evidence from longitudinal models
Panos, S. E., Re, A. C. D., Thames, A. D., Arentsen, T. J., Patel, S. M., Castellon, S. A., Singer, E. J., & Hinkin, C. H. (2013) · AIDS Care · doi:10.1080/09540121.2013.802275 · Cited by 40
“Self-efficacy was measured using the self-efficacy question on the ACTG baseline adherence questionnaire, developed by a panel of experts as part of the Adult AIDS Clinical Trials Group (AACTG; Chesney et al., 2000).”
Method
Predictors of Adherence to Glaucoma Treatment in a Multisite Study
Cook, P. F., Schmiege, S. J., Mansberger, S. L., Kammer, J. A., Fitzgerald, T., & Kahook, M. Y. (2014) · Annals of Behavioral Medicine · doi:10.1007/s12160-014-9641-8 · Cited by 40
“Studies in other chronic diseases have found that 3-day retrospective recall is a valid measure based on detection of nonadherence and correlations with known adherence predictors (33); 3-day recall also correlates significantly with physiological measures and electronic monitoring (34).”
Background
The Cerebrospinal Fluid HIV Risk Score for Assessing Central Nervous System Activity in Persons With HIV
Hammond, E. R., Crum, R. M., Treisman, G. J., Mehta, S. H., Marra, C. M., Clifford, D. B., Morgello, S., Simpson, D. M., Gelman, B. B., Ellis, R. J., et al. (2014) · American Journal of Epidemiology · doi:10.1093/aje/kwu098 · Cited by 41
“Potential predictors included patient demographic characteristics and HIV treatment–related data, including current and nadir CD4+ T-cell counts, plasma and CSF HIV RNA levels, duration of HIV seropositivity, duration and type of cART regimens (i.e., protease inhibitor– vs. nonnucleoside reverse transcriptase inhibito…”
Method
Factors of interpersonal communication and behavioral health on medication self-efficacy and medication adherence
Archiopoli, A. M., Ginossar, T., Wilcox, B., Avila, M., Hill, R., & OETZEL, J. G. (2016) · AIDS Care · doi:10.1080/09540121.2016.1192577 · Cited by 40
“Extant research revealed a link between medication self-efficacy and medication adherence, with medication self-efficacy positively associated with medication adherence (Chesney et al., 2000; Colbert, Sereika, & Erlen, 2013; Reif et al., 2013).”
Background
Self-Report and Dry Blood Spot Measurement of Antiretroviral Medications as Markers of Adherence in Pregnant Women in Rural South Africa
Alcaide, M. L., Ramlagan, S., Rodriguez, V. J., Cook, R., Peltzer, K., Weiss, S. M., Sifunda, S., & Jones, D. L. (2017) · AIDS and Behavior · doi:10.1007/s10461-017-1760-3 · Cited by 40
“[11] To match the maximum number of days covered by the DBS detection window, if the participant reported any missed ARV doses in the past 3 Days, their response was considered nonadherent; those reporting zero missed doses in the past 3 days were considered adherent.”
Background
Role of the HIV/AIDS Case Manager: Analysis of a Case Management Adherence Training and Coordination Program in North Carolina
Shelton, R., Golin, C., Smith, S. R., Eng, E., & Kaplan, A. (2006) · AIDS Patients Care and STDs · doi:10.1089/apc.2006.20.193 · Cited by 39
Cigarette Smokers are Less Likely to Have Undetectable Viral Loads
Cropsey, K. L., Willig, J. H., Mugavero, M. J., Crane, H. M., McCullumsmith, C. B., Lawrence, S. T., Raper, J. L., Mathews, W. C., Boswell, S., Kitahata, M. M., et al. (2015) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000172 · Cited by 40
“…risk, low risk, or at-risk for abuse; Bradley et al., 1998; Gual et al., 2002), adherence (no missed doses or missed any doses in the past 3 months; Chesney et al., 2000), and individual substance use (current use defined as use in the past 3 months, prior use, or no use of marijuana,…”
Background
Validation of a COVID-19 mental health and wellness survey questionnaire
Tantawi, M. E., Foláyan, M. O., Nguyen, A. L., Aly, N. M., Ezechi, O., Uzochukwu, B. S. C., Alaba, O. A., & Brown, B. J. (2022) · BMC Public Health · doi:10.1186/s12889-022-13825-2 · Cited by 40
“Reasons for missed doses of HIV medications were adapted from the AIDS Clinical Trial Group instrument for missing medications [35].”
Method
Global Action to reduce HIV stigma and discrimination
Stangl, A. L., Grossman, C. I., Sidibé, M., Goosby, E., Grossman, C. I., Stangl, A. L., Katz, I. T., Ryu, A. E., Onuegbu, A., Psaros, C., et al. (2013) · Journal of the International AIDS Society · doi:10.7448/ias.16.3.18934 · Cited by 44
Consumer Activism in the Pharmacology of HIV
Rosengarten, M. (2004) · Body & Society · doi:10.1177/1357034x04041762 · Cited by 39
“Pill taking for HIV is acknowledged to be potentially onerous, potentially conspicuous and therefore risky in terms of disclosure (Chesney et al., 2000: 263).”
Background
Development and Pilot Testing of Daily Interactive Voice Response (IVR) Calls to Support Antiretroviral Adherence in India: A Mixed-Methods Pilot Study
Swendeman, D. T., Jana, S., Ray, P., Mindry, D. L., Das, M., & Bhakta, B. B. (2015) · AIDS and Behavior · doi:10.1007/s10461-014-0983-9 · Cited by 40
“AIDS Clinical Trial Group (ACTG) Adherence Measures [4]”
The Importance of Establishing Regimen Concordance in Preventing Medication Errors in Anticoagulant Care
Schillinger, D., Wang, F. M., Rodriguez, M., Bindman, A. B., & Machtinger, E. L. (2006) · Journal of Health Communication · doi:10.1080/10810730600829874 · Cited by 39
“Research assistants asked subjects to report their warfarin adherence using a wellestablished instrument similar to that used in other studies (Chesney et al., 2000; Golin et al., 2002).”
Result
The Role of Adherence in Virological Suppression in Patients Receiving Anti-HBV Analogues
Sogni, P., Carrieri, P., Fontaine, H., Mallet, V. O., Vallet‐Pichard, A., Trabut, J., Méritet, J., & Pol, S. (2011) · Antiviral Therapy · doi:10.3851/imp1944 · Cited by 39
“The first four were adapted for HBV-analogue treatment from the questionnaire established for HIVpositive patients by the AIDS Clinical Trial Group [13], validated in French [14] and then used in HIV studies [15,16].”
Method
Patient-reported outcomes in daily clinical practise in HIV outpatient care
Kjær, A. S. H. K., Rasmussen, T. A., Hjøllund, N. H., Rodkjær, L. Ø., & Storgaard, M. (2018) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2018.02.015 · Cited by 39
Comparison of Antiretroviral Therapy Adherence Among HIV-Infected Older Adults with Younger Adults in Africa: Systematic Review and Meta-analysis
Soomro, N., Fitzgerald, G., Seeley, J., Schatz, E. J., Nachega, J. B., & Negin, J. (2018) · AIDS and Behavior · doi:10.1007/s10461-018-2196-0 · Cited by 41
“acceptable, including AIDS Clinical Trial Group (ACTG) adherence questionnaire [34].”
Method
The Impact of Once-Nightly Versus Twice-Daily Dosing and Baseline Beliefs About HAART on Adherence to Efavirenz-Based HAART Over 48 Weeks: The NOCTE Study
Cooper, V., Horne, R., Gellaitry, G., Vrijens, B., Lange, A.-C., Fisher, M., & White, D. (2010) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e3181ccb762 · Cited by 39
Development and Validation of a Brief Computer-Administered HIV-Related Health Literacy Scale (HIV-HL)
Ownby, R. L., Waldrop‐Valverde, D., Hardigan, P. C., Caballero, J., Jacobs, R. J., & Acevedo, A. (2012) · AIDS and Behavior · doi:10.1007/s10461-012-0301-3 · Cited by 41
Strengthening adherence to Anti Retroviral Therapy (ART) monitoring and support: operation research to identify barriers and facilitators in Nepal
Bam, K., Rajbhandari, R. M., Karmacharya, D. B., & Dixit, S. M. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-0846-8 · Cited by 38
“Study tools Questionnaires looking into client socio-demographics, ART side effects as well as ART adherence information was adapted from Adult AIDS Clinical Trial Group (AACTG) which was translated into Nepali language, pre-tested and modified [12].”
Method
Evaluation of adherence to oral antiviral hepatitis B treatment using structured questionnaires
Giang, L. (2012) · World Journal of Hepatology · doi:10.4254/wjh.v4.i2.43 · Cited by 38
Antiretroviral Therapy Adherence in Persons with HIV/AIDS in Cuba
Aragonés, C., Sánchez, L., Campos, J., & Pérez, J. (2011) · MEDICC Review · doi:10.37757/mr2011v13.n2.6 · Cited by 37
Adherence to combined Antiretroviral therapy (cART) among people living with HIV/AIDS in a Tertiary Hospital in Ilorin, Nigeria
Anyaike, C., Atoyebi, O. A., Musa, O. I., Bolarinwa, O. A., Durowade, K. A., Ogundiran, A., & Babatunde, O. A. (2019) · Pan African Medical Journal · doi:10.11604/pamj.2019.32.10.7508 · Cited by 38
“Also, active substances have been documented as one of the strong predictors of non-adherence [38, 39].”
Background
Sociodemographic factors affecting viral load suppression among people living with HIV in South Carolina
Haider, M. R., Brown, M., Harrison, S., Yang, X.-Y., Ingram, L., Bhochhibhoya, A., Hamilton, A., Olatosi, B., & Li, X.-M. (2019) · AIDS Care · doi:10.1080/09540121.2019.1703892 · Cited by 38
“A uthor M anuscript A uthor M anuscript A uthor M anuscript A uthor M anuscript ART adherence—Self-reported ART adherence was measured by four items adopted from the Adult AIDS Clinical Trials Group adherence instrument (Chesney et al., 2000).”
Method
Feasibility of Nurse-Led Antidepressant Medication Management of Depression in an HIV Clinic in Tanzania
Adams, J., Almond, M., Ringo, E. J., Shangali, W. H., & Sikkema, K. J. (2012) · The International Journal of Psychiatry in Medicine · doi:10.2190/pm.43.2.a · Cited by 38
Adherence to nicotine replacement patch therapy in cardiovascular patients
Wiggers, L. C. W., Smets, E. M. A., Oort, F. J., de Haes, J. C. J. M., Storm-Versloot, M. N., Vermeulen, H., Legemate, D. A., Loenen, L. B. M., & Peters, R. J. G. (2006) · International Journal of Behavioral Medicine · doi:10.1207/s15327558ijbm1301_10 · Cited by 38
Acceptability of Mobile Phone Technology for Medication Adherence Interventions among HIV-Positive Patients at an Urban Clinic
Miller, C. W. T., & Himelhoch, S. (2013) · AIDS Research and Treatment · doi:10.1155/2013/670525 · Cited by 45
Overview and implementation of an intervention to prevent adherence failure among HIV-infected adults initiating antiretroviral therapy: Lessons learned from Project HEART
Davies, G., Koenig, L. J., Stratford, D., Palmore, M., Bush, T., Golde, M., Malatino, E., Todd-Turner, M., & Ellerbrock, T. V. (2006) · AIDS Care · doi:10.1080/09540120500329556 · Cited by 38
“In the AIDS Clinical Trial Group (ACTG), where exclusion criteria and self-selection have contributed to an exceptionally motivated and adherent participant sample, average adherence ranged from 73% to 89% (Chesney et al., 2000).”
Prevalence of and Risk Factors for Substance Use Among Perinatally Human Immunodeficiency Virus–Infected and Perinatally Exposed but Uninfected Youth
Alperen, J. K., Brummel, S. S., Tassiopoulos, K., Mellins, C. A., Kacanek, D., Smith, R. A., Seage, G. R., & Moscicki, A. (2013) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2013.09.003 · Cited by 36
Response to first‐line antiretroviral treatment among human immunodeficiency virus‐infected patients with and without a history of injecting drug use in Indonesia
Wisaksana, R., Indrati, A. R., Fibriani, A., Rogayah, E., Sudjana, P., Djajakusumah, T. S., Sumantri, R., Alisjahbana, B., van der Ven, A. J. A. M., & van Crevel, R. (2010) · Addiction · doi:10.1111/j.1360-0443.2010.02898.x · Cited by 37
Factors associated with medication adherence in patients living with cirrhosis
Polis, S., Zang, L., Mainali, B., Pons, R., Pavendranathan, G., Zekry, A., & Fernandez, R. S. (2015) · Journal of Clinical Nursing · doi:10.1111/jocn.13083 · Cited by 38
Accuracy of measures for antiretroviral adherence in people living with HIV
Smith, R., Villanueva, G., Probyn, K., Sguassero, Y., Ford, N. P., Orrell, C., Cohen, K., Chaplin, M., Leeflang, M., & Hine, P. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013080.pub2 · Cited by 39
Baseline medication adherence and response to an electronically delivered health literacy intervention targeting adherence
Ownby, R. L., Waldrop-Valverde, Caballero, J., & Jacobs, R. J. (2012) · Neurobehavioral HIV Medicine · doi:10.2147/nbhiv.s36549 · Cited by 37
Implementing Behavioral Activation and Life-Steps for Depression and HIV Medication Adherence in a Community Health Center
Magidson, J. F., Seitz‐Brown, C. J., Safren, S. A., & Daughters, S. B. (2013) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2013.10.002 · Cited by 39
“…taken in the past month from 0 to 100% adherence (Giordano, Guzman, Clark, Charlebois, & Bangsberg, 2004) and self-reported frequency of doses missed across a range of common reasons for nonadherence using a section of the AIDS Clinical Trials Group (ACTG) questionnaire (Chesney et al., 2000).”
Method
OROS-methylphenidate efficacy on specific executive functioning deficits in adults with ADHD: A randomized, placebo-controlled cross-over study
Bron, T. I., Bijlenga, D., Boonstra, A. M., Breuk, M., Pardoen, W. F. H., Beekman, A. T. F., & Kooij, J. J. S. (2014) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2014.01.007 · Cited by 38
HIV treatment-related knowledge and self-efficacy among caregivers of HIV-infected children
Nicholson, O., Mellins, C. A., Dolezal, C., Brackis‐Cott, E., & Abrams, E. J. (2005) · Patient Education and Counseling · doi:10.1016/j.pec.2005.05.006 · Cited by 37
Violence From a Sexual Partner is Significantly Associated With Poor HIV Care and Treatment Outcomes Among Female Sex Workers in the Dominican Republic
Mendoza, C., Barrington, C., Donastorg, Y., Perez, M., Fleming, P. J., Decker, M. R., & Kerrigan, D. (2017) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000001250 · Cited by 34
Depressive Symptoms Mediate the Effect of HIV-Related Stigmatization on Medication Adherence Among HIV-Infected Men Who Have Sex with Men
Mitzel, L. D., Vanable, P. A., Brown, J. L., Bostwick, R. A., Sweeney, S. M., & Carey, M. P. (2015) · AIDS and Behavior · doi:10.1007/s10461-015-1038-6 · Cited by 39
The social context of tuberculosis treatment in urban risk groups in the United Kingdom: a qualitative interview study
Craig, G., & Zumla, A. I. (2015) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2015.01.007 · Cited by 36
“For those participants not receiving DOT, a dominant theme was the way treatment regimens impacted on everyday routines, compounded by the number and size of tablets and frequency of dosing.(26) A healthcare worker taking medication for both HIV and TB spoke of the day dominated by pills and the difficulty of taking t…”
Evidence‐based, multifactorial approach to addressing non‐adherence to antiretroviral therapy and improving standards of care
Herrmann, S., McKinnon, E., John, M., Hyland, N., Martinez, O. P., Cain, A., Turner, K., Coombs, A., Manolikos, C., & Mallal, S. A. (2007) · Internal Medicine Journal · doi:10.1111/j.1445-5994.2007.01477.x · Cited by 36
Risk factors for suboptimal antiretroviral therapy adherence in HIV-infected adolescents in Gaborone, Botswana: a pilot cross-sectional study
Nachega, J. B., Maimouna, Nyasulu, Nguyen, Lowenthal, Gross, & Mills, E. J. (2013) · Patient Preference and Adherence · doi:10.2147/ppa.s47628 · Cited by 36
Stigma, discrimination and HIV outcomes among people living with HIV in Rio de Janeiro, Brazil: The intersection of multiple social inequalities
Kerrigan, D. L., Vazzano, A., Bertoni, N., Malta, M., & Bastos, F. I. (2015) · Global Public Health · doi:10.1080/17441692.2015.1064459 · Cited by 36
“Adherence to ART was measured using standard Adult AIDS Clinical Trial Group questions (Chesney et al., 2000), which has been used in previous studies in Brazil (Remien et al., 2007).”
Method
Factors Associated with Adherence and Concordance Between Measurement Strategies in an HIV Daily Oral Tenofovir/Emtricitibine as Pre-exposure Prophylaxis (Prep) Clinical Trial, Botswana, 2007–2010
Kebaabetswe, P. M., Stirratt, M. J., McLellan–Lemal, E., Henderson, F. L., Gray, S. C., Rose, C. E., Williams, T., & Paxton, L. A. (2014) · AIDS and Behavior · doi:10.1007/s10461-014-0891-z · Cited by 36
Quality of life of people living with HIV/AIDS and on highly active antiretroviral therapy in Ethiopia
Beyene, K. A., Gedif, T., Engidawork, E., & Gebre‐Mariam, T. (2010) · African Journal of AIDS Research · doi:10.2989/16085906.2010.484560 · Cited by 36
“Percentage adherence from self-report (given a 15-day recall period) was calculated using the following formula (see Chesney, Ickovics, Chambers, Gifford, Neidig, Zwickl & Wu, 2000): % Adherence = No. of doses patient should have taken –”
Method
Unannounced Telephone-Based Pill Counts: A Valid and Feasible Method for Monitoring Adherence
Fredericksen, R. J., Feldman, B. J., Brown, T., Schmidt, S. M., Crane, P. K., Harrington, R. D., Dhanireddy, S., McReynolds, J., Lober, W. B., Bangsberg, D. R., et al. (2014) · AIDS and Behavior · doi:10.1007/s10461-014-0916-7 · Cited by 36
“The assessment included the following adherence measures: 4-item Adult AIDS Clinical Trial Group (AACTG) instrument [34], a rating scale item [35], and a visual analogue scale item [25, 36, 37].”
Community-Based Participatory Research
Skolarus, L. E., Zimmerman, M. A., Murphy, J. B., Brown, D. L., Kerber, K. A., Bailey, S., Fowlkes, S., & Morgenstern, L. B. (2011) · Stroke · doi:10.1161/strokeaha.110.609495 · Cited by 36
Contrasting predictors of poor antiretroviral therapy outcomes in two South African HIV programmes: a cohort study
Dahab, M., Charalambous, S., Karstaedt, A., Fielding, K., Hamilton, R., Grange, L. L., Churchyard, G., & Grant, A. D. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-430 · Cited by 36
HIV Prevention in Care and Treatment Settings: Baseline Risk Behaviors among HIV Patients in Kenya, Namibia, and Tanzania
Kidder, D. P., Bachanas, P. J., Medley, A. M., Pals, S. L., Nuwagaba‐Biribonwoha, H., Ackers, M., Howard, A. A., DeLuca, N., Mbatia, R., Sheriff, M., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0057215 · Cited by 36
Veterans aging cohort three-site study (VACS 3)
Smola, S., Justice, A. C., Wagner, J., Rabeneck, L., Weissman, S., & Rodriguez‐Barradas, M. C. (2001) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(01)00448-6 · Cited by 36
Adapting a Family-Based HIV Prevention Program for HIV-Infected Preadolescents and Their Families
McKay, M. M., Block, M., Mellins, C. A., Traube, D. E., Brackis‐Cott, E., Minott, D., Miranda, C., Petterson, J., & Abrams, E. J. (2007) · Social Work in Mental Health · doi:10.1300/j200v05n03_06 · Cited by 36
“These therapies have created challenges for both youth as well as their adult caregivers (Mellins et al., 2003; Chesney et al., 2000).”
Background
Factors Influencing Antiretroviral Adherence and Virological Outcomes in People Living with HIV in the Highlands of Papua New Guinea
Gare, J., Kelly‐Hanku, A., Ryan, C. E., David, M., Kaima, P., Imara, U., Lote, N., Crowe, S. M., & Hearps, A. C. (2015) · PLoS ONE · doi:10.1371/journal.pone.0134918 · Cited by 35
Autonomous Regulation and Locus of Control as Predictors of Antiretroviral Medication Adherence
Lynam, I. M., Catley, D., Goggin, K., Rabinowitz, J. L., Gerkovich, M. M., Williams, K. B., Wright, J., & MOTIV8, &. (2009) · Journal of Health Psychology · doi:10.1177/1359105309103577 · Cited by 36
“This measure has been used successfully in previous studies ofAIDS adherence behavior (Chesney et al., 2000) and for this study had an alpha of .87.”
BackgroundMethodInfluential

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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