Trial reportPloS one2014
Psychosocial predictors of non-adherence and treatment failure in a large scale multi-national trial of antiretroviral therapy for HIV: data from the ACTG A5175/PEARLS trial.
Trial report in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Healthy Aging in Older Women Living with HIV Infection: a Systematic Review of Psychosocial Factors.Current HIV/AIDS reports · 2017Pooled it
- Early Progression and Immune Reconstitution Inflammatory Syndrome During Treatment of Mild-To-Moderate Kaposi Sarcoma in Sub-Saharan Africa and South America: Incidence, Long-Term Outcomes, and Effects of Early Chemotherapy.Journal of acquired immune deficiency syndromes (1999) · 2020Trial
- Quality of life among HIV-infected individuals failing first-line antiretroviral therapy in resource-limited settings.AIDS care · 2018Trial
- Herpes Simplex Virus Type 2 Acquisition Among HIV-1-Infected Adults Treated With Tenofovir Disoproxyl Fumarate as Part of Combination Antiretroviral Therapy: Results From the ACTG A5175 PEARLS Study.The Journal of infectious diseases · 2017Trial
- Trial
- Concurrent Anemia and Elevated C-Reactive Protein Predicts HIV Clinical Treatment Failure, Including Tuberculosis, After Antiretroviral Therapy Initiation.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Trial
- Adherence to Early Antiretroviral Therapy: Results From HPTN 052, a Phase III, Multinational Randomized Trial of ART to Prevent HIV-1 Sexual Transmission in Serodiscordant Couples.Journal of acquired immune deficiency syndromes (1999) · 2015Trial
- Pre-antiretroviral therapy serum selenium concentrations predict WHO stages 3, 4 or death but not virologic failure post-antiretroviral therapy.Nutrients · 2014Trial
- Differences in antiretroviral safety and efficacy by sex in a multinational randomized clinical trial.HIV clinical trialsTrial
- Gender Differences in Statin Discontinuation and Adherence Among Privately Insured People with HIV in the USA.Journal of general internal medicine · 2026 · on this mapObservational
- Evaluating the Efficacy of Repurposed Antiretrovirals in Hepatitis B Virus Treatment: A Narrative Review of the Pros and Cons.International journal of molecular sciences · 2025Review
- HIV Pre-exposure Prophylaxis Use Among Men Experiencing Incarceration in the United States: A Prospective Cohort Study.Journal of acquired immune deficiency syndromes (1999) · 2025Observational
- Changes in Adherence and Viral Load Suppression Among People with HIV in Manila: Outcomes of the Philippines Connect for Life Study.AIDS and behavior · 2024Article
- Development and feasibility testing of an integrated PTSD and adherence intervention cognitive processing therapy-life steps (CPT-L) to improve HIV outcomes: Trial protocol.Contemporary clinical trials communications · 2023Article
- Dolutegravir resistance in three pregnant and breastfeeding women in South Africa.Southern African journal of HIV medicine · 2023Article
- Low-Burden Universal Substance Use Screening in a Primary Care Clinic to Lower Implementation Barriers.The journal of behavioral health services & research · 2023Article
- Interactive Mobile Phone HIV Adherence Support for Men Who Have Sex With Men in the Philippines Connect for Life Study: Mixed Methods Approach to Intervention Development and Pilot Testing.JMIR formative research · 2022Article
- Factors associated with barriers to engagement in HIV-prevention care among sexual minority men.Journal of behavioral medicine · 2021Article
- Poor quality of life and incomplete self-reported adherence predict second-line ART virological failure in resource-limited settings.AIDS care · 2021Article
- Prevalence and factors associated with intimate partner violence after HIV status disclosure among pregnant women with depression in Tanzania.AIDS care · 2021Article
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
backgroundPEARLS, a large scale trial of antiretroviral therapy (ART) for HIV (n = 1,571, 9 countries, 4 continents), found that a once-daily protease inhibitor (PI) based regimen (ATV+DDI+FTC), but not a once-daily non-nucleoside reverse transcriptase inhibitor/nucleoside reverse transcriptase inhibitor (NNRTI/NRTI) regimen (EFV+FTC/TDF), had inferior efficacy compared to a standard of care twice-daily NNRTI/NRTI regimen (EFV+3TC/ZDV). The present study examined non-adherence in PEARLS.
methodsOutcomes: non-adherence assessed by pill count and by self-report, and time to treatment failure. Longitudinal predictors: regimen, quality of life (general health perceptions = QOL-health, mental health = QOL-mental health), social support, substance use, binge drinking, and sexual behaviors. "Life-Steps" adherence counseling was provided.
resultsIn both pill-count and self-report multivariable models, both once-a-day regimens had lower levels of non-adherence than the twice-a-day standard of care regimen; although these associations attenuated with time in the self-report model. In both multivariable models, hard-drug use was associated with non-adherence, living in Africa and better QOL-health were associated with less non-adherence. According to pill-count, unprotected sex was associated with non-adherence. According to self-report, soft-drug use was associated with non-adherence and living in Asia was associated with less non-adherence. Both pill-count (HR = 1.55, 95% CI: 1.15, 2.09, p<.01) and self-report (HR = 1.13, 95% CI: 1.08, 1.13, p<.01) non-adherence were significant predictors of treatment failure over 72 weeks. In multivariable models (including pill-count or self-report nonadherence), worse QOL-health, age group (younger), and region were also significant predictors of treatment failure.
conclusionIn the context of a large, multi-national, multi-continent, clinical trial there were variations in adherence over time, with more simplified regimens generally being associated with better adherence. Additionally, variables such as QOL-health, regimen, drug-use, and region play a role. Self-report and pill-count adherence, as well as additional psychosocial variables, such QOL-health, age, and region, were, in turn, associated with treatment failure.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.