Table 3.
Summary of statistical findings of HAC with non-PK adherence measures
| Study | N | Characteristics of non-PK adherence measure | HAC Characteristics | Statistical method | Result a |
|---|---|---|---|---|---|
| Self-report | |||||
| Abaasa et al., 2018 | 43 | Self-reported pill taking in the last 28 days [median(IQR)]: 7 (7–7) doses per week for Uganda; 7 (6–7) doses per week for Kenya | HAC of TFV [median(IQR)]: 0.07 (0.05–0.11) ng/mg for Uganda; 0.07 (0.03–0.08) ng/mg for Kenya | Pearson correlation | r = −0.01(NS) and −0.20 (NS) for MSM and seronegative partners of PLWH, respectively |
| Bartelink et al., (2014) | 96 | Self-reported the percentage of pill taken was categorized into five categories:<75%, ≥75–85%, ≥85–95%, ≥95–99%, and ≥99% | HAC of LPV, RTV and EFV (range):1.1–13, 0.06–1.35, and 0.4–34 ng/mg | Not specified | Not association (test statistic N/R) |
| Baxi et al., 2015 | 88 | Self-reported pill taking in the last 28 days: N/R | HAC of TFV and FTC: N/R | Pearson correlation; Regression analysis |
r = 0.34** and 0.38***! for TFV and FTC at 8 weeks, respectively; r = 0.24 and 0.33** for TFV and FTC at 16 weeks, respectively. OR 1.04 (95% CI 1.00–1.08), p<0.05 for TFV; OR 1.06 (95% CI 1.03–1.09), p<0.05 for TFV |
| Baxi et al., 2018 | 47 | Self-reported the percentage of pill taken using VAS in the last month [median (IQR)]: 90% (90%−90%) | HAC of TFV [median(range)]: 0.05(0.01–0.21) ng/mg | Spearman correlation; Regression analysis |
r = 0.06 (NS); OR 6% (95%CI −12%−25%), p=0.50; ORA 5% (95%CI −13%−24%), p=0.59 |
| Chawana et al. 2017 | 50 | Self-reported the percentage of pill taken using VAS was categorized into three categories:<80%, ≥80–94%, and ≥95%; Self-reported closely following dosing schedule in the past 4 days was categorized into two categories: yes or no | HAC of ATV was categorized into two categories: adequate (>2.35ng/mg) and inadequate (≤2.35ng/mg) | Chi-square and Student t tests | p=0. 507 for VAS; p=0.061 for 4-day dosing schedule; p = 0.031 for change in self-reported adherence using VAS. |
| Gandhi et al., 2011 | 424 | Self-reported the percentage of pill taken using VAS in the past 6 month was categorized into two categories: <95% and ≥95% | HAC of ATV: N/R | Not specified | p< 0.001(test statistic: N/R) |
| Gandhi et al., 2012 | 87 | Self-reported the percentage of pill taken using VAS in the past 6 month was categorized into three categories: ≤74%, 75–95%, and ≥95% | HAC of EFV [median(range)]: 3.11 (0.05–41.4) pg/mg | regression analysis | ORA 1.00 for ≤74%; ORA 0.94 (95%CI 0.45–1.96), p = 0.88 for 75–95%; ORA 1.11 (95%CI 0.56–2.2), p = 0.77 for≥95% |
| Hickey et al., 2014 | 307 | Self-reported the percentage of pill taken using the AIDS Clinical Trials Group (ACTG) adherence questionnaire in past 4 days [median (IQR)]: 100% (96% −100%) | HAC of NVP [median(IQR)]: 75.1 (42.1–108.1) pg/mg | regression analysis | OR 1.91 (95%CI 0.42–8.7), p = 0.43; ORA 1.72 (95%CI 0.42–7.1), p = 0.45 |
| Koss et al., 2017 | 47 | Self-reported pill taking in the last 7 days: N/R | HAC of TFV [median(IQR)]: 2.4 (BLQ-16.8) pg/mg | Spearman correlation | r = 0.10 (NS) |
| Koss et al., 2018 | 243 | Self-reported the percentage of pill taken using VAS in the past 30 days [median (IQR)]: 90% (70%−100%) | HAC of TFV and FTC [median(range)]: 0.013(0.002–0.32) ng/mg and 0.16(0.02–2.84) ng/mg | Spearman correlation | r = 0.28*** and 0.29*** for TFV and FTC, respectively |
| Olds et al., 2014 | 121 | Self-reported the percentage of pill taken using caregiver interview in past three days and VAS in the past 30 days [median (IQR)]: 100% (100–100) and 100% (98–102) | HAC of TFV [median(IQR)]: 76.7 (27.7–125.7) ng/mg | Unvariate regression analysis | OR 1.10 (95%CI 0.83–1.45) p=0.51 for Three-day caregiver recall; OR 1.20 (95%CI 0.97–1.49), p=0.091 for 30-day VAS |
| Pill counts | |||||
| Baxi et al., 2018 | 47 | Announced pill counts in the past 90 days [median (IQR)]: 97.9% (80%−109%) | HAC of TFV median(range): 0.05(0.01–0.21) ng/mg | Spearman correlation Regression analysis |
r = 0.38*; OR 12% (95%CI 4%−21%), p=0.003; ORA 12% (95%CI 4%−20%), p=0.005 |
| Olds et al., 2014 | 121 | Unannounced pill counts [median (IQR)]: 96.1% (87.4–104.8) | HAC of TFV [median(IQR)]: 76.7 (27.7–125.7) ng/mg | Univariate regression analysis | OR 0.96 (95%CI 0.90–1.01), p=0.11 |
| Electronic drug monitoring | |||||
| Abaasa et al., 2018 | 43 | Pill bottle cap opening in the past 28 days [median (IQR)] openings per week 7 (6–7) for Uganda; 5 (4–7) for kenya | HAC of TFV [median(IQR)]: 0.07 (0.05–0.11) ng/mg for Uganda; 0.07 (0.03–0.08) ng/mg for Kenya | Pearson correlation | r = 0.41** and 0.85** for seronegative of PLWH partners and MSM, respectively |
| Baxi et al., 2015 | 88 | Pill bottle cape openings: N/R | HAC of TFV and FTC: N/R | Pearson correlation Regression analysis |
r = 0.50*** and 0.58*** for TFV and FTC at 8 weeks, respectively. r=0.62*** and 0.73*** for TFV and FTC for TFV at 16 weeks, respectively; OR 1.08 (95%CI 1.06–1.10) for TFV, OR 1.10 (95%CI 1.08–1.12) for FTC, all p<0.05; ORA 1.08 (95%CI 1.06–1.10) for TFV; ORA 1.11 (95%CI 1.09–1.13) for FTC, all p<0.05 |
| Baxi et al., 2018 | 47 | Pill bottle cap openings in the past 90 days [median (IQR)]: 87% (77%−93%) | HAC of TFV [median(range)]: 0.05(0.01–0.21) ng/mg | Pearson correlation | r = 0.20*; OR 2% (95% CI −5%−9%), p=0.52; ORA 2% (95% CI −5%−9%), p=0.50. |
| Koss et al., 2018 | 243 | Pill bottle cap openings in the past 30 days [median (IQR)]: 3 (IQR, 0–35.5) | HAC of TFV and FTC [median(range)]: .013(0. 002–0.32) ng/mg and 0.16(0.02–2.84) ng/mg | Pearson correlation | r = 0.40*** and 0.36*** for TFV and FTC, respectively |
| Olds et al., 2014 | 121 | Pill bottle cap openings [median (IQR)]: 96.1% (87.4–104.8) | HAC of NVP [median(IQR)]: 76.7 | Regression analysis | OR 1.16 (95% CI 0.93–1.44), p=0.19 |
Note.
*
p<0.05
**
p<0.01
***
p<0.001
HAC=hair ARV concentration; non-PK=non-pharmacokinetic; N/R=not reported; EDM=Electronic drug monitoring; VAS=visual analog scale; TFV=Tenofovir; FTC=Emtricitabine; EFV=Efavirenz; NVP=Nevirapine; LPV=Lopinavir; RTV=Ritonavir; ATV=Atazanavir; MSM= men who have sex with man; OR=odds ratios; HR = Hazard ratios; M=mean; SD=standard deviation; IQR=interquartile range.
a
Odds ratios, hazard ratios, and relative risks are unadjusted unless denoted by subscript “A”.