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Adherence to and effectiveness of Highly Active Antiretroviral Treatment for HIV infection : assessing the bidirectional relationship


Author Info

  • Lamiraud, Karine

    (ESSEC Business School)

  • Moatti,, Jean-Paul

    (ORS PACA, Center for Disease Control of Southeastern France, Marseille, France)

  • Raffi, François

    (CHU Nantes, Nantes, France)

  • Carrieri, Maria-Patrizia

    (ORS PACA, Center for Disease Control of Southeastern France, Marseille, France)

  • Protopopescu, Camelia

    (ORS PACA, Center for Disease Control of Southeastern France, Marseille, France)

  • Michelet, Christian

    (CHU de Rennes, Rennes, France)

  • Schneider, Luminita

    (Service des Maladies Infectieuses et tropicales, Hôpital Pitié-Salpêtrière, Paris, France)

  • Collin, Fideline

    (INSERM, U897, Bordeaux, Franc)

  • Leport, Catherine

    (Laboratoire de recherche en pathologie infectieuse, Université Paris 7, Hôpital Bichat AP-HP, Paris, France)

  • Spire, Bruno

    (ORS PACA, Center for Disease Control of Southeastern France, Marseille, France)


It is well-established that high adherence to HAART is a major determinant of virological and immunological success. Furthermore, psycho-social research has identified a wide range of adherence factors. Our objective was to assess the bi-directional relationship between adherence and response to treatment among patients enrolled in the ANRS CO8 APROCOCOPILOTE study. An econometric approach was implemented through a bivariate twoequation simultaneous system, studying the factors associated with both adherence and undetectability of HIV plasma viral load. Our results highlight that good biological results induced by adherence reinforce continued adherence. This strengthens the argument that patients who do not experience rapid improvements in their immunological and clinical statuses after HAART initiation should be prioritized whendeveloping adherence support interventions. Furthermore, it rules out the hypothesis that HAART leads to “false reassurance” among HIV infected patients.

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Bibliographic Info

Paper provided by ESSEC Research Center, ESSEC Business School in its series ESSEC Working Papers with number WP1110.

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Length: 33 pages
Date of creation: 01 Jan 2011
Date of revision:
Handle: RePEc:ebg:essewp:dr-11010

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Postal: ESSEC Research Center, BP 105, 95021 Cergy, France
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Related research

Keywords: Adherence; HIV; relationship between adherence and effectiveness; simultaneous equations; GEE;

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  1. Guilkey, David K. & Murphy, James L., 1993. "Estimation and testing in the random effects probit model," Journal of Econometrics, Elsevier, vol. 59(3), pages 301-317, October.
  2. Gourieroux, Christian & Monfort, Alain & Trognon, Alain, 1984. "Pseudo Maximum Likelihood Methods: Theory," Econometrica, Econometric Society, vol. 52(3), pages 681-700, May.
  3. Jeffrey M Wooldridge, 2002. "Simple solutions to the initial conditions problem in dynamic, nonlinear panel data models with unobserved heterogeneity," CeMMAP working papers CWP18/02, Centre for Microdata Methods and Practice, Institute for Fiscal Studies.
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