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TOPLINE:

A recent study found that antiretroviral therapy adherence below 90% was associated with significantly lower odds of viral suppression among women living with HIV.

METHODOLOGY:

• Researchers analyzed data from community-based prospective cohort study including women living with HIV across British Columbia, Ontario, and Quebec between 2013 and 2018.
• Overall, 1187 participants (median age, 42 years) who reported antiretroviral therapy use and specified their regimen were included in the analysis.
• Participants completed questionnaire surveys at three timepoints, at 18 months interval between 2013 and 2018.
• Analysis focused on the relationship between adherence to antiretroviral therapy and viral suppression using data from the study period between 2017 and 2018.

TAKEAWAY:

• The use of integrase strand transfer inhibitors increased from 13.6% in 2013 to 30.6% in 2018, whereas the utilization of other antiretroviral classes showed declining trends.
• Among participants, 78.2% reported undetectable viral loads, and viral suppression was achieved by 89.6% of those on regimens consisting of a backbone plus a third agent.
• Less than 70% adherence (adjusted odds ratio [aOR], 0.06; 95% CI, 0.01-0.27) and 80%-89% adherence (aOR, 0.21; 95% CI, 0.05-0.86) were associated with lower odds of viral suppression compared with ≥ 95% adherence.
• Researchers found no significant difference in the odds of viral suppression between 90%-94% adherence and ≥ 95% adherence.

IN PRACTICE:

“With the chronic nature of HIV and the risk of resistance, supporting patients in overcoming the challenges that accompany long-term medication adherence through cotailored approaches should remain a priority when providing care to women living with HIV,” the authors wrote.

SOURCE:

The study was led by Alexandra de Pokomandy, Department of Family Medicine, McGill University, Montreal, Quebec, Canada. It was published online on May 2, 2025, in HIV Medicine.

LIMITATIONS:

The study was limited by a small sample size in groups with lower adherence, which may have reduced the statistical power to detect significant differences. All measures were self-reported, introducing social desirability bias and recall bias. The study also lacked information on the status of mental health treatment and the duration of viral suppression. 

DISCLOSURES:

The study received funding from the Canadian Institutes of Health Research, the Canadian HIV Trials Network, the Ontario HIV Treatment Network, and the Ontario Academic Health Science Centers Alternative Funding Plans Innovation. Two authors reported having financial ties with several pharmaceutical companies. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.