Self-reported zidovudine adherence among pregnant women with human immunodeficiency virus infection in four US states

OBJECTIVE: Our purpose was to identify clinical and psychosocial factors as sociated with rates of prenatal zidovudine use and adherence among human im munodeficiency virus-infected pregnant women. STUDY DESIGN: Two hundred sixty-four women completed 2 interviews between O ctober 1996 and November 1998 at prenatal clinics in Miami, Florida; Brookl yn, New York; Connecticut; and North Carolina. Interviews took place after 24 weeks' gestation and then between 32 weeks and delivery. RESULTS: Prenatal zidovudine had been prescribed for 94% of the women, 37% of whom received monotherapy. Among women taking zidovudine, 20% reported i ncomplete adherence. In multivariate analyses having missed zidovudine dose s was positively associated with prenatal illicit drug use (odds ratio, 3.4 9; 95% confidence interval, 1.30-9.42; P <.05) and missing prenatal vitamin s (odds ratio, 2.71;95% confidence interval, 1.30-5.67; P<.01). CONCLUSIONS: Zidovudine therapies have been successfully implemented in pre natal care settings in the United States. The success of these therapies ma y be limited among some patients by incomplete regimen adherence, particula rly among illicit drug users.