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 associated with rates of prenatal zidovudine use and adherence among human immunodeficiency virus-infected pregnant women. STUDY DESIGN: Two hundred sixty-four women completed 2 interviews between October 1996 and November 1998 at prenatal clinics in Miami, Florida; Brooklyn, 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 incomplete adherence. In multivariate analyses having missed zidovudine doses was positively associated with prenatal illicit drug use (odds ratio, 3.49; 95% confidence interval, 1.30-9.42; P <.05) and missing prenatal vitamins (odds ratio, 2.71;95% confidence interval, 1.30-5.67; P<.01). CONCLUSIONS: Zidovudine therapies have been successfully implemented in prenatal care settings in the United States. The success of these therapies may be limited among some patients by incomplete regimen adherence, particularly among illicit drug users.