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- Title
An Index of Multiple Psychosocial, Syndemic Conditions Is Associated with Antiretroviral Medication Adherence Among HIV-Positive Youth.
- Authors
Kuhns, Lisa M.; Hotton, Anna L.; Garofalo, Rob; Muldoon, Abigail L.; Jaffe, Kaitlyn; Bouris, Alida; Voisin, Dexter; Schneider, John
- Abstract
Medication adherence among HIV-infected individuals is critical to limit disease progression and onward transmission. Evidence indicates that among youth living with HIV (YLH), adherence is suboptimal and related to co-morbid psychosocial conditions. Cross-sectional data from 212 YLH, ages 16-29, collected between 2011-2014 in Chicago were analyzed to assess the relationship of multiple psychosocial conditions (e.g., depressive symptoms, anxiety symptoms, moderate/heavy marijuana use, moderate/heavy alcohol use, HIV-related stigma) to ART adherence (i.e., a 'syndemic.') Adherence was regressed on an index of increasing numbers of psychosocial conditions, controlling for demographic and treatment factors as well as enrollment site. The mean age of participants was 24, 89% were male, 87% black, and 91% behaviorally infected. Psychosocial conditions were prevalent, including 38% and 34% with high depressive and anxiety symptoms, respectively, 54% and 25% with a moderate/high level of marijuana and alcohol use, respectively, and 46% reporting high HIV-related stigma. In regression analysis, the likelihood of ART adherence decreased with the number of syndemic conditions (linear dose response, p = 0.02) as did the odds of viral load suppression ( p = 0.008). Interventions to address these conditions in concert with biomedical treatment as prevention for YLH are needed.
- Subjects
ILLINOIS; CLINICAL drug trials; ANTIVIRAL agents; ANXIETY; CHI-squared test; CONFIDENCE intervals; MENTAL depression; FISHER exact test; HIV infections; RESEARCH methodology; PATIENT compliance; REGRESSION analysis; RESEARCH funding; SCALE analysis (Psychology); SELF-evaluation; STATISTICS; SUBSTANCE abuse; COMORBIDITY; DATA analysis; VIRAL load; RANDOMIZED controlled trials; VISUAL analog scale; CROSS-sectional method; DESCRIPTIVE statistics; ODDS ratio; MANN Whitney U Test; KRUSKAL-Wallis Test; BRIEF Symptom Inventory; ADOLESCENCE
- Publication
AIDS Patient Care & STDs, 2016, Vol 30, Issue 4, p185
- ISSN
1087-2914
- Publication type
Article
- DOI
10.1089/apc.2015.0328