Joint Models as an Integrated Approach for Behavioral and Biological Outcomes in HIV Adherence Research

• Activity Number: 487
• Type: Topic Contributed
• Date/Time: Wednesday, August 6, 2014 : 10:30 AM to 12:20 PM
• Sponsor: Committee on Minorities in Statistics
• Author(s): Scarlett L. Bellamy*+ and Erica Billig and Robert Gross
• Companies: University of Pennsylvania Perelman School of Medicine and University of Pennsylvania and University of Pennsylvania Perelman School of Medicine
• Keywords: joint models ; HIV

Abstract

Adherence to prescribed antiretroviral (ARV) treatment regimens is critical to successful management of HIV. Managed Problem Solving (MAPS) was developed as a behavioral modification intervention to improve medication adherence. Few interventions have successfully demonstrated improvements in both adherence and virologic outcomes. In a randomized controlled trial comparing MAPS to usual care, efficacy of MAPS was demonstrated increasing adherence to ARV treatment. However, although favoring MAPS, there was no demonstrated difference in virologic failure. In a secondary analysis, we sought to determine whether a joint modeling approach integrating the evaluation of MAPS for both the behavioral and biological outcome simultaneously would yield more statistical power than the prior analysis which treated each outcome separately. Additionally, we conducted a simulation study to quantify gains in efficiency comparing the independent analyses of two outcomes compared to a joint modeling approach for scenarios in similar studies involving the evaluation of behavioral and biological outcomes in behavioral modification trials.