Bastard M. auteur aut IRD Fall M. B. K. auteur aut IRD Lanièce I. auteur aut IRD Taverne Bernard auteur aut IRD Desclaux Alice auteur aut IRD Ecochard R. auteur aut IRD Sow P. S. auteur aut IRD Delaporte Eric auteur aut IRD Etard Jean-François auteur aut IRD text journalArticle eng text/pdf born digital access Background: Adherence is one of the main predictors of antiretroviral treatment success. A governmental initiative was launched in 1998 for HIV-infected patients in Senegal to provide access to highly active antiretroviral therapy. Methods: Between August 1998 and April 2002, 404 adult patients were enrolled. Adherence measurements, defined as pills taken/pills prescribed, were assessed between November 1999 and April 2009 using a pill count along with a questionnaire for 330 patients. Predictors of adherence were explored through a random-intercept Tobit model and a latent class analysis (LCA) was performed to identify adherence trajectories. We also performed a survival analysis taking into account gender and latent adherence classes. Results: Median treatment duration was 91 months (interquartile range, 84-101). On average, adherence declined by 7% every year, was 30% lower for patients taking indinavir, and 12% higher for those receiving cotrimoxazole prophylaxis. Based on the predicted probability of having an adherence >= 95%, LCA revealed 3 adherence behaviors and a better adherence for women. A quarter of patients had a high adherence trajectory over time and half had an intermediate one. Male gender and low adherence behavior over time were independently associated with a higher mortality rate. Conclusions: This study shows that an overall good adherence can be obtained in the long term in Senegal. LCA suggests a better adherence for women and points out a large subsample of patients with intermediate level of adherence behavior who are at risk for developing resistance to antiretroviral drugs. This study warrants further research into gender issues. specialized antiretroviral therapy adherence latent class analysis mixed model women Senegal 052 57 1 55-61 2011 1525-4135 https://www.documentation.ird.fr/hor/fdi:010053486 10.1097/QAI.0b013e318211b43b 1525-4135 [F B010053486] https://www.documentation.ird.fr/hor/fdi:010053486 https://www.documentation.ird.fr/intranet/publi/2011/05/010053486.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2011-05-31 2017-08-23 fdi:010053486 fre