General Health Status and Adherence to Antiretroviral Therapy

Cardarelli, Roberto; Weis, Stephen E.; Adams, Elvin; Radaford, Debbie; Vecino, Isabel; Munguia, Guadalupe; Johnson, Katandria Love; Fulda, Kimberly

doi:10.1177/1545109708318526

Cited by 16 publications

(13 citation statements)

References 45 publications

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“…Similar to our finding, Cardarelli and colleagues [35] reported that individuals who perceived their health as fair or poor were several times more likely to have poorer adherence to their antiretroviral medications. This implies that general health status may serve as a proxy for stress, depression and other psychosocial variables that negatively impact adherence and health [36].…”

Section: Discussionsupporting

confidence: 91%

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

et al. 2011

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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.

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Section: Discussionsupporting

confidence: 91%

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

et al. 2011

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“…Specifically, whereas Cardarelli et al [46], Rao et al [57], Sayles et al [53], and Tyer-Viola et al [51] all found significant univariate associations between stigma and self-reported adherence among PLWH, these associations diminished to non-significance at the multivariate level, with other factors including mental health symptoms, depressive symptoms, and perceived general health status emerging as significant predictors. In another investigation [52], a combined stigma measure composed of four subscales (i.e., stereotypes of HIV, disclosure concerns, renegotiating social relationships, self-acceptance) was associated with adherence in univariate analyses, but adherence failed to predict any of the individual stigma subscales at the multivariate level.…”

Section: Studies That Combined Multiple Dimensions Of Stigmamentioning

confidence: 91%

“…The most frequently used measure was an original or modified version of Berger's HIV Stigma Scale [46][47][48][49][50][51], which includes four subscales of personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes. In other investigations, stigma was assessed through a variety of instruments including the HIV Internalized Stigma Measure [52,53], HIV/AIDS Stigma Instrument-PLWA [54], Self-Stigma Scale [55], HIV/AIDS-related Stigma and Discrimination [56], Stigma Scale for Chronic Illness [57], and items selected from the Patient Medication Adherence Questionnaire [52].…”

Section: Studies That Combined Multiple Dimensions Of Stigmamentioning

confidence: 99%

The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

2015

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This paper provides a review of the quantitative literature on HIV-related stigma and medication adherence, including: (1) synthesis of the empirical evidence linking stigma to adherence, (2) examination of proposed causal mechanisms of the stigma and adherence relationship, and (3) methodological critique and guidance for future research. We reviewed 38 studies reporting either cross-sectional or prospective analyses of the association of HIV-related stigma to medication adherence since the introduction of antiretroviral therapies (ART). Although there is substantial empirical evidence linking stigma to adherence difficulties, few studies provided data on psychosocial mechanisms that may account for this relationship. Proposed mechanisms include: (a) enhanced vulnerability to mental health difficulties, (b) reduction in self-efficacy, and (c) concerns about inadvertent disclosure of HIV status. Future research should strive to assess the multiple domains of stigma, use standardized measures of adherence, and include prospective analyses to test mediating variables.

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“…Factors that been shown to affect antiretroviral adherence include age [8][9][10], HIV risk factor [11], general health status [12], living with children [13], patients' beliefs about their need for ART and their concerns about potential adverse effects of ART [14,15], frequency and severity of symptoms [8,16,17], stressful life events [18], depression [19][20][21][22][23], mistrust of the medical system [24], HIV stigma [25], and health literacy independent of education [26]. Further, adherence can vary over the course of HIV infection [27].…”

Section: Introductionmentioning

confidence: 99%

Once Daily Dosing Improves Adherence to Antiretroviral Therapy

Raboud

Walmsley

et al. 2010

AIDS Behav

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We studied the association of once-daily dosing with self-reported adherence among participants of the Ontario Cohort Study who were currently taking ART and who had completed a 90-min interviewer-administered questionnaire. Suboptimal adherence was defined as missing ≥1 dose of ART in the 4 days prior to the interview. Participants (n = 779) were 85% male, 69% men having sex with men, 67% white, median age 48 years (IQR 42-54), median years of ART 9 (IQR 5-13) and median CD4 count 463 cells/mm(3) (IQR 320-638). Fifteen percent of participants reported suboptimal adherence in the 4 days prior to the interview. In a multivariable logistic regression model, participants on once daily regimens were half as likely to miss a dose during the 4 days prior to the interview. Other independent correlates of suboptimal adherence were younger age, lower positive social interaction and increased frequency of consuming > 6 alcoholic drinks on one occasion.

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General Health Status and Adherence to Antiretroviral Therapy

Abstract: General health status was the strongest predictor of HAART nonadherence, and future research is needed to assess whether this 1-question general health measure can be clinically used to influence adherence.

Cited by 16 publications

References 45 publications

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

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

The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

Once Daily Dosing Improves Adherence to Antiretroviral Therapy

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