Online Program

Gender differences in PTSD and HIV treatment adherence

Tuesday, November 3, 2015

Sage Kim, PhD, University of Illinois at Chicago, Chicago, IL
Lawrence J. Ouellet, PhD, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, IL
Mary Ellen Mackesy-Amiti, PhD, Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL
Chad Zawitz, M.D., John H. Stroger Hospital and CORE Center, Cermak Health Services, Chicago, IL
Background: Adherence to treatment among HIV-positive individuals is a key factor affecting treatment outcomes and infection transmission.  For those who have a history of incarceration compared with individuals with HIV infection in the general population, adhering to treatment may be even more challenging, in part due to limited resources, risky lifestyles, and frequent encounters with the criminal justice system. 

Studies have shown that women who experienced traumatic experiences including childhood abuse and adulthood violence are more likely to have depressive symptoms which lead to poor adherence to HIV treatment. 

Studies have documented that higher levels of social support may improve treatment adherence, but gender differences in treatment adherence and the effects of PTSD on social support and adherence have not been fully explored, particularly among inmates. 

Methods: We analyzed 243 men and women with HIV infection incarcerated in a large county jail in Chicago. 

Results: Overall, those who had stopped taking HIV medication before incarceration were more likely to be women, younger and to have more severe substance use issues.  In addition, women compared with men and those who scored higher on trauma symptomology had more severe substance use problems.  Older inmates and those with more severe trauma symptoms had a lower level of social support.  Social support and the level of trauma were significantly associated. 

Conclusion: We conclude that women are more likely to stop taking HIV medication in part due to trauma symptoms that directly and indirectly influence social support and substance severity.

Learning Areas:

Advocacy for health and health education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Compare the levels of PTSD and HIV treatment adherence between female and male inmates; Discuss potential pathways between PTSD, social support, and treatment adherence.

Keyword(s): Treatment Adherence, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified because I have conducted research concerning incarceration, substance use, and HIV/STIs for the past 15 years. I have been PI and Co-I on research projects that aim to improve healthcare for the incarcerated population. I have published and presented on this topic using this and related datasets.
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.