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Realtime adherence monitoring of antiretroviral therapy among hiv-infected adults and children in rural uganda

Haberer, Jessica E.a,b,c; Kiwanuka, Juliusd; Nansera, Denisd; Muzoora, Conradd; Hunt, Peter W.e; So, Jacquelyne; O’Donnell, Michaela; Siedner, Marka; Martin, Jeffrey N.e; Bangsberg, David R.a,b,c,d

doi: 10.1097/QAD.0b013e328363b53f
Research Letters

A real-time wireless electronic adherence monitor (EAM) and weekly self-report of missed doses via interactive voice response (IVR) and short message service (SMS) queries were used to measure antiretroviral therapy adherence in 49 adults and 46 children in rural Uganda. Median adherence was 89.5% among adults and 92.8% among children by EAM, and 99–100% for both adults and children by IVR/SMS self-report. Loss of viral suppression was significantly associated with adherence by EAM (odds ratio 0.58 for each 10% increase), but not IVR/SMS. Wireless EAM creates an exciting opportunity to monitor and potentially intervene with adherence challenges as they are happening.

aMassachusetts General Hospital

bHarvard Medical School, Boston

cRagon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA

dMbarara University of Science and Technology, Mbarara, Uganda

eUniversity of California, San Francisco, California, USA.

Correspondence to Jessica E. Haberer, MGH Center for Global Health, 100 Cambridge St, 15th floor, Boston, MA 02114, USA. Tel: +1 617 724 0351; fax: +1 671 724 1637; e-mail:

Received 5 May, 2013

Revised 19 May, 2013

Accepted 29 May, 2013

© 2013 Lippincott Williams & Wilkins, Inc.