265180 Correlates of poor anti-retroviral (ARV) adherence among a sample of HIV+ adults in Haiti: Implications for intervention

Monday, October 29, 2012

Anshul Saxena, BDS , AIDS Prevention Program, Florida International University, Miami, FL
Sankalp Das, BDS , AIDS Prevention Program,Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Jennifer Attonito, MS , AIDS Prevention Program,Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Michèle Jean-Gilles, Ph.D. , Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Jessy G. Dévieux, Ph.D. , Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Robert M. Malow, PhD , AIDS Prevention Program, Florida International University, Miami, FL
Background: Haiti has the highest number of HIV-infected persons in the Caribbean region. Behavioral interventions to promote adherence to ARV treatment are considered critical to improving outcomes of HIV/AIDS programs. In this study we determine the factors associated with non-adherence to ARV medication among a sample of males and females (N= 257, ♂=98, ♀=159; mean age= 35.39 ± 8.44 years) enrolled in an ongoing NIH/NIAAA funded study designed to simultaneously enhance safer sex practices, adherence to ARV medication, and reduce the use of alcohol or other drugs. Methods: Baseline data on medication adherence as well as background characteristics and mental health were analyzed using independent sample t-tests, chi square and Pearson correlation. Measures included self-reported adherence using the modified Access & Utilization of Care (AUC) instrument, the Beliefs about Medicines Questionnaire (BMQ), the State-Trait Anxiety Inventory (STAI), and the Center for Epidemiological Studies Depression scale (CES-D). Results: The majority of the participants (75%) were prescribed ARVs, and 83% reported 100% adherence. Significant correlates of non-adherence were female gender (χ2 (1) =5.414, p=.02), state anxiety (r=0.148. p=0.041), trait anxiety (r=0.146, p=0.043), and worry about taking ARV medication (r=-0.166, p=0.021). Females also reported significantly higher mean depression (t=-3.98, p=0.0001) and trait anxiety scores (t=-2.63, p=0.009) than males. Conclusions: This study found significant associations between gender, anxiety, depression, worry about ARVs, and reported non-adherence among our sample of HIV-infected adults in Haiti. The results suggest that interventions with this population should specifically address women's mental health concerns.

Learning Areas:
Administer health education strategies, interventions and programs
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related education
Social and behavioral sciences

Learning Objectives:
Describe factors related to poor anti-retroviral (ARV) adherence among a sample of HIV+ adults in Haiti.

Keywords: Adherence, Antiretroviral Combination Therapy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I helped in abstract writing while working as a graduate assistant at the dept of health promotion and disease prevention
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.