Predictors of adherence to ARV treatment among seropositive population in Russia

Background and purpose: HIV is a major public health problem in Russia. Limited research has explained low levels of adherence to ARV treatment among Russia's HIV-positive population. The present study examines predictors of adherence to ARV treatment among HIV-positive urban dwellers in St. Petersburg, Russia.

Methods: The total sample of 301 seropositive individuals living in St. Petersburg, aged 18 to 40 (Males, N=135; Females, N=166), were randomly recruited. Data were collected via self-administered questionnaires. Primary measures included adherence to ARV treatment, drug and alcohol use, mutuality with the PCP, coping strategies, propensity towards risk behavior, and tendency to search for new sensations. The primary analytic method relied on Bell-Trevino modeling and Poisson regression. Higher order interaction analyses were conducted using product terms to examine the potential moderating effects of gender and age.

Results: Maladaptive coping strategies, e.g. disclaiming and escape-avoidance, as well as use of drugs and alcohol, and the tendency to search for new sensations were related to low adherence to ARV treatment. Gender differences in adherence to ARV treatment were found significant only when analyzed in interaction with age.

Conclusions and implications: While adherence to ARV treatment among Russia's HIV-positive population should be addressed in protective interventions, coping strategies and substance use should be a focus of such intervention. Also, interventions should be tailored to age and gender groups, and take into the account patients' behavioral characteristics, such as propensity to searching for new sensations.