Self-report and dry blood spot measurement of antiretroviral medications as markers of adherence in pregnant women in rural South Africa

Antiretroviral (ARV) adherence is essential to prevent mother-to-child transmission of HIV. This study compared self-reported adherence versus ARV detection in dried blood spots (DBS) among N = 392 HIV-infected pregnantwomen in SouthAfrica (SA).Women completed two self-reported adherence measures [visual analog scale (VAS), AIDS Clinical Trials Group Adherence (ACTG)]. Adherence was 89% (VAS), 80% (ACTG), and 74% (DBS). Self-report measuresmarginally agreed withDBS(VAS:Kappa = 0.101, Area under the ROC curve (AUROC) = 0.543; ACTG: Kappa = 0.081,AUROC = 0.538). Self-reported adherence was overestimated and agreement with DBS was poor. Validation of self-reportedARVadherence among pregnant HIV women in SA is needed.