High Concordance between Self-Reported Adherence, Treatment Outcome and Satisfaction with Care Using a Nine-Item Health Questionnaire in InfCareHIV

PLoS One. 2016 Jun 16;11(6):e0156916. doi: 10.1371/journal.pone.0156916. eCollection 2016.


Background: In this cross-sectional study we present an integrated analysis of a self-reported Health Questionnaire and socio-demographic and treatment outcome data from the national Swedish HIV cohort, InfCareHIV.

Objectives: To evaluate the Health Questionnaire and identify the main determinants of adherence.

Methods: A total of 2,846 patients answered a nine-item disease-specific Health Questionnaire between 2012 and 2014, corresponding to 44% of all active patients in the national InfCareHIV cohort. The questionnaire assessed patient related outcome measures (PROMs) regarding health and antiretroviral treatment (ART) and patient related experience measures (PREMs) regarding involvement in care and satisfaction with the care provider.

Result: We found the Health Questionnaire to be valid and reliable when used in ordinary clinical practice. There was a high concordance between self-reported adherence to ART in the past seven days and treatment outcome, with 94% of patients who reported optimal adherence having a viral load <50 copies/ml. The main determinants of optimal adherence were heterosexual transmission path, being born in Sweden, being male, not reporting experience of ART side effects and being fully satisfied with care.

Conclusion: The nine-item Health Questionnaire can identify patients at risk of treatment failure, those in need of clinical assessment of adverse events and those with impaired physical health.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • Cross-Sectional Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Personal Satisfaction*
  • Quality of Life / psychology*
  • Self Report
  • Surveys and Questionnaires
  • Sweden
  • Treatment Outcome
  • Viral Load / drug effects*


  • Anti-HIV Agents

Grants and funding

This work was supported by the Stockholm County Council (www.sll.se), Gilead Nordic Fellow program (www.Gilead.com), and the Swedish Association of Local Authorities and Regions (www.kvalitetsregister.se). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.