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Readiness: The State of the Science (or the Lack Thereof)

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Abstract

HIV treatment guidelines state that patients’ readiness should be assessed before initiating highly active antiretroviral therapy (HAART) to assure adherence. None of the guidelines provide a way to measure readiness. Therefore, this article sought to review the literature on readiness to determine if there was a viable predictor of adherence. Twenty-seven articles were reviewed. Nine described studies that examined the relationship between a measure of readiness and HAART adherence. No readiness measure demonstrated clinical utility as a predictor of adherence. Study flaws included small sample sizes (only one study >100 patients), short follow-up periods (all ≤1 year and six were ≤5 months, four ≤1 month), measures of readiness that related poorly to adherence, and inconsistent adherence measures (eight different measures were used by the researchers). Neither the guidelines nor the literature will help clinicians judge who should initiate HAART and who should delay treatment.

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References

Papers of particular interests, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgment

This study was supported by the Baylor-UT Houston Center for AIDS Research (CFAR), a National Institutes of Health–funded program (AI036211).

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No potential conflicts of interest relevant to this article were reported.

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Correspondence to Richard M. Grimes.

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Grimes, R.M., Grimes, D.E. Readiness: The State of the Science (or the Lack Thereof). Curr HIV/AIDS Rep 7, 245–252 (2010). https://doi.org/10.1007/s11904-010-0056-2

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