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

  • Karine Lamiraud

    (Economics Department - ESSEC Business School)

  • Jean-Paul Moatti

    (SE4S - Sciences économiques et sociales, systèmes de santé, sociétés - INSERM : U912 - IRD - Université de la Méditerranée - Aix-Marseille II - ORS PACA)

  • François Raffi

    (Maladies infectieuses et tropicales)

  • Maria Patrizia Carrieri

    (SE4S - Sciences économiques et sociales, systèmes de santé, sociétés - INSERM : U912 - IRD - Université de la Méditerranée - Aix-Marseille II - ORS PACA)

  • Camelia Protopopescu

    (SE4S - Sciences économiques et sociales, systèmes de santé, sociétés - INSERM : U912 - IRD - Université de la Méditerranée - Aix-Marseille II - ORS PACA)

  • Christian Michelet

    (Service des maladies infectieuses et réanimation médicale - Hôpital Pontchaillou - Université de Rennes 1)

  • Luminita Schneider

    (Service des maladies infectieuses et tropicales - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Pitié-Salpêtrière - Université Paris VI - Pierre et Marie Curie)

  • Fidéline Collin

    (Centre épidémiologie et biostatistique - INSERM : U897 - Université Victor Segalen - Bordeaux II)

  • Catherine Leport

    (Laboratoire de recherche en pathologie infectieuse - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Bichat - Claude Bernard - Université Paris VII - Paris Diderot)

  • Bruno Spire

    (SE4S - Sciences économiques et sociales, systèmes de santé, sociétés - INSERM : U912 - IRD - Université de la Méditerranée - Aix-Marseille II - ORS PACA)

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 when developing adherence support interventions. Furthermore, it rules out the hypothesis that HAART leads to "false reassurance" among HIV infected patients.

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Paper provided by HAL in its series Post-Print with number hal-00660923.

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Date of creation: 01 Jan 2011
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Handle: RePEc:hal:journl:hal-00660923
Note: View the original document on HAL open archive server: http://hal-essec.archives-ouvertes.fr/hal-00660923
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  1. Gourieroux, Christian & Monfort, Alain & Trognon, Alain, 1984. "Pseudo Maximum Likelihood Methods: Theory," Econometrica, Econometric Society, vol. 52(3), pages 681-700, May.
  2. 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.
  3. 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.
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