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APHA Scientific Session and Event Listing

Recorded presentation

Nicola Christofides, MPH¹, Ralph DiClemente, PhD², Gina Wingood, MPH ScD², Delia Lang, MPH PhD², Lara DePadilla, MS², and Kristin Dunkle, MPH PhD². (1) Rollins School of Public Health, Center for AIDS Research, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, 404 667 1457, njchris@emory.edu, (2) Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, 1518 Clifton Rd NE, Atlanta, GA 30322

Background: Adherence to HAART is critical if treatment is to be successful. Researchers have begun uncovering factors associated with adherence; however, research among women in the US is limited. This study aimed to identify factors that predict adherence to HAART among HIV positive women Methods: Women (N=366) recruited from clinics in 2 southern states in the US as part of a randomized behavioral intervention trial completed a structured personal interview. The interview assessed sociodemographics, psychosocial factors that may influence HAART adherence, use of complementary and alternative treatments and adherence to HAART. Non-adherence was defined as having missed any dose in the previous 30 days. We conducted logistic regression analysis controlling for education level. Results: The majority of women (78.4%, n=287) were receiving HAART; of these, 37.98% were non-adherent. Greater spirituality (OR=0.88, CI= 0.80-0.98), lower self-rated health (OR=0.42, CI= 0.23-0.74) and higher personal control (OR=0.55, CI=0.32-0.94) were protective against non-adherence to treatment. Complementary/alternate treatment was associated with non-adherence (OR=1.94, CI=1.11-3.40) as was increased time-since-diagnosis (5-9 years post diagnosis OR=3.13, CI=1.38-6.94; 10-15 years post-diagnosis OR=3.10, CI=1.38-6.94). Conclusions: Providers need to consider the full range of potential medical and social complexities of the lives of women living with HIV when prescribing medicine and encouraging adherence. Spirituality and personal control may provide purpose in women's lives. While poor health may be a motivator to sustain medication adherence, length of time since diagnosis may lead to treatment fatigue and lack of motivation.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• List two psychosocial indicators that protect HIV positive women against non-adherence to HAART;
• List at least two risk factors for non-adherence among women living with HIV;
• Describe the similarities and differences between the findings of this study looking at HIV positive women and other studies that have explored adherence to ART;
• Apply the findings to health service provision.

Keywords: Adherence, Women and HIV/AIDS

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation