European Business Schools Librarian's Group

ESSEC Working Papers,
ESSEC Research Center, ESSEC Business School

No WP1110: Adherence to and effectiveness of Highly Active Antiretroviral Treatment for HIV infection : assessing the bidirectional relationship

Karine Lamiraud (), , Jean-Paul Moatti (), François Raffi (), Maria-Patrizia Carrieri (), Camelia Protopopescu (), Christian Michelet (), Luminita Schneider (), Fideline Collin (), Catherine Leport () and Bruno Spire ()
Additional contact information
Karine Lamiraud: ESSEC Business School, Postal: Avenue Bernard Hirsch - B.P. 50105, 95021 CERGY PONTOISE Cedex, FRANCE
, Jean-Paul Moatti: ORS PACA, Center for Disease Control of Southeastern France, Marseille, France
François Raffi: CHU Nantes, Nantes, France
Maria-Patrizia Carrieri: ORS PACA, Center for Disease Control of Southeastern France, Marseille, France
Camelia Protopopescu: ORS PACA, Center for Disease Control of Southeastern France, Marseille, France
Christian Michelet: CHU de Rennes, Rennes, France
Luminita Schneider: Service des Maladies Infectieuses et tropicales, Hôpital Pitié-Salpêtrière, Paris, France
Fideline Collin: INSERM, U897, Bordeaux, Franc
Catherine Leport: Laboratoire de recherche en pathologie infectieuse, Université Paris 7, Hôpital Bichat AP-HP, Paris, France
Bruno Spire: ORS PACA, Center for Disease Control of Southeastern France, Marseille, France

Abstract: 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.

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

33 pages, January 1, 2011

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