Mediators of antiretroviral adherence: A multisite international study

Corless, Inge B.; Guarino, A. J.; Nicholas, Patrice K.; Tyer-Viola, Lynda; Kirksey, Kenn M.; Brion, John; Rose, Carol Dawson; Eller, Lucille Sanzero; Rivero-Méndez, Marta; Kemppainen, Jeanne; Nokes, Kathleen M.; Sefcik, Elizabeth; Voss, Joachim; Wantland, Dean; Johnson, Mallory O.; Phillips, J. Craig; Webel, Allison R.; Iipinge, Scholastika; Portillo, Carmen J.; Chen, W. T.; Maryland, Mary; Hamilton, Mary Jane; Reid, Paula; Hickey, Dorothy E.; Holzemer, William L.; Sullivan, Kathleen M.

doi:10.1080/09540121.2012.701723

Cited by 16 publications

(15 citation statements)

References 43 publications

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“…Recent non-adherence (18.9%) surpassed the median rate found in a 6-country study (13.3%) (Corless et al, 2012) and rates reported in comparable China-based samples (Corless et al, 2012; L. Li, Ji, Ding, Tian, & Lee, 2012; Sabin et al, 2010; Simoni et al, 2011).…”

Section: Discussioncontrasting

confidence: 52%

Suboptimal antiretroviral therapy adherence among HIV-infected adults in Guangzhou, China

Muessig

McLaughlin²,

Min

et al. 2014

AIDS Care

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Despite China“s free antiretroviral treatment (ART) program, there are high rates of treatment failure, large sociodemographic disparities in care outcomes and emerging medication resistance. Understanding patient medication adherence behaviors and challenges could inform adherence interventions to maximize the individual and prevention benefits of ART. This study assessed recent non-adherence and treatment interruption among 813 HIV-infected adult outpatients in Guangzhou, China. Participants completed a behavioral survey, underwent chart review, and were tested for syphilis, gonorrhea, and chlamydia. Factors associated with suboptimal adherence were identified using univariate and multivariate logistic regression. Among 721 HIV-infected adults receiving ART, 18.9% reported recent non-adherence (any missed ART in the past 4 weeks) and 6.8% reported treatment interruption (four or more weeks of missed ART in the past year). Lower education, living alone, alcohol use and being on ART one to three years were associated with recent non-adherence. Male gender, lower education and being on ART one to three years were associated with treatment interruption. ART medication adherence interventions are needed in China that include individualized, long-term adherence plans sensitive to patients“ educational and economic situations. These interventions should also consider possible gender disparities in treatment outcomes and address the use of alcohol during ART. Successful ART medication adherence interventions in China can inform other international settings that face similar adherence challenges and disparities.

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Section: Discussioncontrasting

confidence: 52%

Suboptimal antiretroviral therapy adherence among HIV-infected adults in Guangzhou, China

Muessig

McLaughlin²,

Min

et al. 2014

AIDS Care

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“…Support for adherence self-efficacy predicted adherence behavior, among our participants and may partially mediate environmental influences and cognitive or personal factors [59]. Additionally, factors that mediate HIV antiretroviral adherence among participants include sense of coherence (“overall well-being and ability to cope with stress” [86]), self-compassion, and engagement in care [58]. The information from these studies highlights the effects of individual and interpersonal level factors that influence adherence among our participants and suggest that additional structural factors may also influence adherence.…”

Section: Discussionmentioning

confidence: 99%

“…This study used structural level data obtained from publically available data sources and individual level survey data obtained from the International Nursing Network for HIV Research Study V [37,58,59]. The International Nursing Network for HIV Research is an interprofessional network of researchers with extensive experience conducting clinical research with PLWH globally [60].…”

Section: Methodsmentioning

confidence: 99%

“…The parent study was also approved at sites in China, Namibia, and Thailand by the Shanghai Public Health Clinic Center Institution Review Board; Ethics Committee of the Ministry of Health and Social Services, Namibia; Ethics Committee of the University of Namibia; and The Ethical Committee of Lerdsin Hospital, Governmental Hospital, Bangkok, Thailand. The demographic characteristics and methods of this study have been previously published [37,58,61]. Selected demographic, survey, and environmental contextual data relevant to the aims of this study are presented.…”

Section: Methodsmentioning

confidence: 99%

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Associations between the legal context of HIV, perceived social capital, and HIV antiretroviral adherence in North America

et al. 2013

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BackgroundHuman rights approaches to manage HIV and efforts to decriminalize HIV exposure/transmission globally offer hope to persons living with HIV (PLWH). However, among vulnerable populations of PLWH, substantial human rights and structural challenges (disadvantage and injustice that results from everyday practices of a well-intentioned liberal society) must be addressed. These challenges span all ecosocial context levels and in North America (Canada and the United States) can include prosecution for HIV nondisclosure and HIV exposure/transmission. Our aims were to: 1) Determine if there were associations between the social structural factor of criminalization of HIV exposure/transmission, the individual factor of perceived social capital (resources to support one’s life chances and overcome life’s challenges), and HIV antiretroviral therapy (ART) adherence among PLWH and 2) describe the nature of associations between the social structural factor of criminalization of HIV exposure/transmission, the individual factor of perceived social capital, and HIV ART adherence among PLWH.MethodsWe used ecosocial theory and social epidemiology to guide our study. HIV related criminal law data were obtained from published literature. Perceived social capital and HIV ART adherence data were collected from adult PLWH. Correlation and logistic regression were used to identify and characterize observed associations.ResultsAmong a sample of adult PLWH (n = 1873), significant positive associations were observed between perceived social capital, HIV disclosure required by law, and self-reported HIV ART adherence. We observed that PLWH who have higher levels of perceived social capital and who live in areas where HIV disclosure is required by law reported better average adherence. In contrast, PLWH who live in areas where HIV transmission/exposure is a crime reported lower 30-day medication adherence. Among our North American participants, being of older age, of White or Hispanic ancestry, and having higher perceived social capital, were significant predictors of better HIV ART adherence.ConclusionsTreatment approaches offer clear advantages in controlling HIV and reducing HIV transmission at the population level. These advantages, however, will have limited benefit for adherence to treatments without also addressing the social and structural challenges that allow HIV to continue to spread among society’s most vulnerable populations.

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“…Free-living exercise can help PLWH overcome structural barriers, including a lack of transportation and cost of fitness facilities, to regular exercise. Additionally, it also may help to decrease barriers caused by HIV-related symptoms and the increased work associated with necessary HIV self-management (Corless et al, 2012; Nokes et al, 2012; Webel, Asher, et al, 2012). …”

Section: Potential Advantages Of Free-living Exercise In Plwhmentioning

confidence: 99%

A Cross-Sectional Description of Age and Gender Differences in Exercise Patterns in Adults Living With HIV

Webel

Barkley

Longenecker

et al. 2015

Journal of the Association of Nurses in AIDS Care

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People living with HIV (PLWH) are living longer and are at greater risk for chronic comorbidities (e.g., cardiovascular disease, cancer) compared to those not living with HIV. Regular, sustained exercise can prevent and/or mitigate the severity of these comorbidities. Our purpose was to describe patterns of planned exercise implemented in the home setting (i.e., free-living exercise) in PLWH by gender and age. PLWH (n = 102) completed a sociodemographic survey and a 7-day exercise diary documenting daily exercise duration, frequency, and intensity. Women exercised an average of 2.4 (IQR: 0.5, 6.0) hours per week compared to men who exercised 3.5 (IQR: 0.5, 7.5) hours per week (p = 0.18). This relationship was particularly evident during middle adulthood for women versus for men (p = 0.05). PLWH exercised regularly but at less than recommended levels. This is among the first evidence describing free-living exercise patterns of PLWH.

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Mediators of antiretroviral adherence: A multisite international study

Cited by 16 publications

References 43 publications

Suboptimal antiretroviral therapy adherence among HIV-infected adults in Guangzhou, China

Suboptimal antiretroviral therapy adherence among HIV-infected adults in Guangzhou, China

Associations between the legal context of HIV, perceived social capital, and HIV antiretroviral adherence in North America

A Cross-Sectional Description of Age and Gender Differences in Exercise Patterns in Adults Living With HIV

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