Strict adherence to HAART is essential to improving health outcomes among people living with HIV. In the past, numerous studies have shown cross-sectional adherence rates among samples of HIV-infected individuals and analyzed differences in adherence among subgroups at one point in time. However, because adherence is seldom evaluated as a longitudinal process, little is known about the stability of adherence over time, or the stability of variables that may impact adherence over time, such as substance use or stable housing. This research utilizes data from 10 projects that provide multi-faceted adherence support interventions using a network of HIV medical and non-medical providers. Baseline and quarterly client interviews include demographic, psychosocial, and adherence-related information, with 3-day self report being the standardized measure of adherence. The stability of behavior from baseline to first quarter was measured with transition matrices, which display the probability of an event occurring at follow-up, given the presence or absence of that event at baseline. Results indicate modest stability effects associated with correlates of poor adherence. The probability of substance use at quarter 1, given its presence at baseline, was .45. Stability effects associated with other correlates of adherence include lack of stable housing (.57), transportation problems (.28), alcohol consumption (.56), and lack of social support (.65). Poor adherence exhibited a stability effect of .45. Off-diagonal probabilities from states of adherence to non-adherence and vice versa are also reported and analyzed within categories of gender, race/ethnicity, and age. See N/A
Learning Objectives: Learning Objectives: At the conclusion of the session, the participant (learner) in the session will be able to: 1. Describe the stability of adherence to HAART over time in this client cohort and how this varies among demographic subgroups. 2. Recognize the intermediate variables associated with adherence (i.e., drug use, stable housing) and how their occurrence fluctuates over time among demographic subgroups. 3. Articulate the importance of understanding adherence as a complex, longitudinal process. 4. Apply this perspective to other research studies to critically analyze the potential limitations of cross-sectional study designs.
Keywords: Adherence, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.