Partner Reports of Patients' HIV Treatment Adherence

Abstract

Decades of clinical research have documented the positive impact of supportive social interactions on health promotion and health outcomes.1, 2 This is particularly relevant in the context of HIV prevention and care, in which the social environment is characterized by stigma, shame, and homophobia, and where persons living with HIV have higher likelihood of substance abuse, depression, and anxiety. These forces threaten successful management of HIV disease, which often depends on timely initiation of and careful adherence to antiretroviral therapy (ART). Given the social context of HIV disease management, the role of spouses and partners in supporting HIV treatment adherence is gaining interest in clinical research and practice. High rates of ART adherence are critical to optimize clinical outcomes, but how to measure adherence is a resilient debate in HIV research and practice.3 The most common approach employs self-reports of adherence, and several such measures have demonstrated evidence of reliability and validity when compared to criteria such as electronic medication monitoring and HIV viral load. However, there is no doubt that selfreported adherence data are eroded by bias, including social desirability and memory effects that contribute to inflated estimates of adherence. The current analyses were conducted to determine whether partners’ reports of patients’ adherence are a better gauge of medication adherence than self-report by the patient.