Open AccessAntiretroviral Adherence Trajectories Among Black Americans Living with HIV
Author(s) -
Erik D. Storholm,
Laura M. Bogart,
Matt G. Mutchler,
David J. Klein,
Bonnie Ghosh-Dastidar,
Bryce McDavitt,
Glenn Wagner
Publication year - 2018
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-018-2303-2
Subject(s) - health psychology , multinomial logistic regression , public health , ethnic group , human immunodeficiency virus (hiv) , demography , logistic regression , interpersonal communication , medicine , gerontology , psychology , antiretroviral treatment , environmental health , clinical psychology , antiretroviral therapy , social psychology , family medicine , viral load , sociology , nursing , machine learning , computer science , anthropology
Black people living with HIV (BPLWH) are less likely to adhere to antiretroviral treatment than are members of other racial/ethnic groups. Data were combined from two studies of BPLWH (n = 239) to estimate adherence trajectories using a semiparametric, group-based modeling strategy over three time-points (spanning 6 months). Analyses identified three groups of individuals (high-stable, moderately low-stable, low-decreasing). Multinomial logistic regressions were used to predict trajectory membership with multiple levels of socio-ecological factors (structural, institutional/health system, community, interpersonal/network, individual). Older age was associated with being in the high-stable group, whereas substance use, lower perceived treatment effectiveness, and lower quality healthcare ratings were related to being in the moderately low-stable group. In sum, multiple socio-ecological factors contribute to adherence among BPLWH and thus could be targeted in future intervention efforts.