The Longitudinal Impact of Psychosocial Syndemic Variables on Adherence to Antiretroviral Therapy Among People With HIV in Brazil, Thailand, and Zambia: An Analysis by HIV Transmission Groups in HPTN 063.
Carlos E Rodríguez-Díaz, Sahar Z Zangeneh, Yumei O Chen, Xu Guo, Kiyomi Tsuyuki, Yusuf Ransome, Ruth K Friedman, Kriengkrai Srithanaviboonchai, Sarah T Roberts, Matthew J Mimiaga, Kenneth H Mayer, Steven A Safren
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引用次数: 0
Abstract
In the field of HIV prevention and care, most studies of HIV syndemic problems are cross-sectional, few differentiate by HIV transmission groups, and few focus on people living with HIV (PWH). We analyzed one-year longitudinal data of 692 sexually active PWH (heterosexual men [HM], heterosexual women [HW], and men who have sex with men [MSM]) in care from Brazil, Thailand, and Zambia. Syndemic scores (0-3+) included stimulant use, polydrug use, depression, alcohol use, and fear of discrimination. Overall, syndemic scores were associated with lower ART adherence over time, but this differed across sexual transmission categories. For HM and HW, those with 2 or 3+ syndemic problems had lower odds of ART adherence than those with none. However, for MSM, the association between syndemic scores and ART adherence was not significant. While syndemic problems generally predicted suboptimal ART adherence among PWH, the association appears nuanced across subgroups.
期刊介绍:
Presenting state-of-the-art research and information, AIDS Education and Prevention is a vital addition to the library collections of medical schools, hospitals, and other institutions and organizations with HIV/AIDS research programs. The journal integrates public health, psychosocial, sociocultural, and public policy perspectives on issues of key concern nationally and globally.