A Binational Study of Patient-Initiated Changes to Antiretroviral Therapy Regimen Among HIV-positive Latinos Living in the Mexico–U.S. Border Region

Abstract

Research is lacking on factors associated with antiretroviral therapy (ART) sub-optimal adherence among U.S. Latinos, who are disproportionately affected by HIV and face substantial health care barriers. We examined self-reported, patient-initiated changes to ART (i.e., made small/major changes from the antiretroviral drugs prescribed) among HIV-positive Latinos. Trained interviewers administered surveys to 230 participants currently on ART in San Diego, U.S. and Tijuana, Mexico. We identified factors independently associated with ART changes. Participants were Spanish-language dominant (86%), mean age of 41 years, male (77%), and born in Mexico (93%). Patient-initiated changes to ART were reported in 43% of participants. Being female, having ≥1 sexual partner (past 3 months), ≥6 years since HIV diagnosis and poor health were associated with increased odds of ART changes. Findings raise concern about sub-optimal adherence among this binational population. Longitudinal studies are needed to further explore adherence barriers and avenues for intervention.

Choosing Sides: HIV Health Care Practices among Shared Populations of HIV-Positive Latinos Living near the US-Mexico Border

“…Details have been published elsewhere. 20 The current analysis included participants who reported their most recent HIV-related medical visit (within the past 6 months) in San Diego or Tijuana. This study was approved by the University of California, San Diego (UCSD) Human Research Protection Program and the Bioethics Committee of the Tijuana General Hospital.…”

Conceptualisations of masculinity and self-reported medication adherence among HIV-positive Latino men in Los Angeles, California, USA

“…Among Latinos, medication adherence has been associated with the quality of the patient-physician relationship and emotional or informational support (van Servellen and Lombardi 2005). Poorer adherence among Latinos has also been found among women, those with one or more sexual partners in the previous three months, those diagnosed with HIV for six or fewer years, those of poor health (Zuniga et al 2012), and those using complementary and alternative medicine (Jernewall et al 2005). Very limited attention has been given to the role that Latino cultural factors may play in medication adherence among HIV-positive Latinos.…”

The Important Role of Binational Studies for Migration and Health Research: A Review of US‐Mexico Binational Studies and Design Considerations for Addressing Critical Issues in Migrant Health

“…Eight studies focused on infectious disease prevalence or risk factors (Garfein, ; Barton‐Behravesh et al., ; Goodman et al., ; O'Rourke et al., ; Giuliano et al., ; Zúñiga et al., ; Servin et al., ; Centers for Disease Control and Prevention, ). Additional inclusions were mental health and substance use studies, (Salgado et al., ; Pinedo et al., ; Russell et al., ; Borges et al., ; Leiner et al., ; Orozco et al., ; Robertson et al., ) studies on social support (Guendelman et al., ; Guendelman et al., ), on lead poisoning, (Villalobos et al., ), and on use of health services and health care‐related behaviours (Holmes, ; Bergmark, Barr and Garcia, ; Rivera et al., ; Stallones et al., ).…”