207854 Main partner factors associated with worse HAART adherence among U.S. women

Monday, November 9, 2009

Amy Knowlton, ScD , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Cui Yang , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Amy Bohnert, PhD , Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Lawrence Wissow, MD, MPH , Johns Hopkins University, Baltimore, MD
Geetanjali Chander, MD , Johns Hopkins School of Medicine, Baltimore, MD
Julia H. Arnsten, MD, MPH , Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
Studies indicate that U.S. women have worse HIV treatment outcomes compared to men. Examining effects of main partners on women's HAART adherence may inform theories of social influences on health, and the development of interventions to reduce gender disparities in HAART outcomes. This study examined ≥90% adherence to HAART among community-sampled women (n=104) in Baltimore, Maryland. 63% had a main partner, 27% an HIV seropositive main partner, and 32% reported emotional support from their partner; 46% were using illicit drugs, 85% were African American, and 51% reported high depressive symptoms (CES-D≥20). Adherence was highest among those with no main partner (92%) and lowest among those with an HIV seropositive main partner (57%). Adjusted analysis indicated adherence was 75% less likely among women with an HIV seropositive main partner, and, independently, 78% less likely among those perceiving emotional support from their partner. Mental confusion and attitudes toward HAART were also significant. The findings indicate the need for intervention to promote HAART adherence among women with main partners, and suggest the potential utility of HIV seroconcordant couples-focused intervention that enhances mutual support of HAART adherence. Future research should examine sources as well as forms of social support important to HAART adherence, and explore women's partners' characteristics and potential informal caregiving burdens to help explain study results.

Learning Objectives:
1. Describe gender differences found in prior findings on HAART use and outcomes in the U.S. 2. Discuss some gender differences found in prior findings on social support and health outcomes. 3. Explain potential explanations for why women's partner status is associated with their worse HAART adherence, with special reference to gender roles.

Keywords: Adherence, Women and HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a researcher with expertise in social environmental influences on medical adherence among U.S. inner city populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Contemporary Issues in HIV Prevention and Care
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