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P-318

P-318. Mean adherence over 6 months (%). Minimum level. Background. Results. China has one of the fastest growing HIV epidemics in the world; HIV is spreading most rapidly in border provinces like Yunnan

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P-318

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  1. P-318 Mean adherence over 6 months (%) Minimum level Background Results • China has one of the fastest growing HIV epidemics in the world; HIV is spreading most rapidly in border provinces like Yunnan • China is rapidly scaling up antiretroviral therapy (ART) but treatment programs are at an early stage, especially outside major urban centers and in border provinces like Yunnan • ART requires high adherence to be effective, but little is known about: • levels of adherence among Chinese patients • how best to measure adherence in Chinese populations Table 2. Correlation among different adherence measures China Self-Report Overestimates Adherence: Electronic Drug Monitoring vs. Self-Report among HIV-Positive Patients in Yunnan, ChinaResults from the “Adherence for Life” study Table 3. Correlation between adherence measures and change in CD4 cell counts after 6 months. Table 1: Patient Demographics Objectives • Determine ART adherence rates among Chinese patients using multiple methods • Self-reports • Pill counts • Electronic data monitoring (EDM) • Determine which measure is most accurate, using change in CD4 as the biological outcome measure Figure 2: Scatter plots of individual patient adherence patterns (dose timing) Sabin L1., Gill C1., Bachman DeSilva M1, Wilson, I2 ,Bobo M1, Zhang J3, Tao L1, Wu W1, Xu K4, and Hamer D1 1Center for International Health and Development, Boston University School of Public Health, Boston, MA, U.S.A. 2Tufts University, Boston, MA, U.S.A. 3Ditan Hospital, Beijing, China. 4Dali Second People’s Hospital, Dali, China Methods • Followed 80 HIV-positive patients in Dali for 6 months, • Collected monthly adherence data using 3 methods • Calculated associations among self-reported adherence, pill counts, and EDM measures over six months using Spearman correlations • Calculated association between each adherence measure and change in CD4 count between baseline and six months Figure 1: Average adherence, multiple measures Conclusions • Measured adherence varies substantially among the three adherence methods • Very strong association between adherence via EDM and changes in CD4. • Self reported adherence rates are unrealistically high • No association between self report and changes in CD4 • Self report does not accurately measure adherence in this population • EDM is most accurate measure for predicting change in CD4 • Individual level data suggest that EDM could be very useful for characterizing adherence patterns and detecting early declines in adherence Acknowledgements Thanks to: Mary Jordan, Billy Pick, David Stanton, Lois Bradshaw, Neal Brandes, Connie Osborne, Ray Yip, Ann Hendricks, Steven Safren, and Anna Knapp. Special thanks to the medical staff at the Dali Second People’s Hospital as well as the Dali-based HIV/AIDS patients. Maximum level

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