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Factors associated with adherence to highly active antiretroviral therapy in homeless or unstably housed adults living with HIV.
AIDS Care. 2009 Apr; 21(4):448-55.AC

Abstract

The aim of this study is to investigate adherence to highly active antiretroviral therapy (HAART) in persons living with HIV/AIDS (PLWHA) who are homeless or unstably housed. We evaluated homeless or unstably housed PLWHA (n=644) in three US cities were enrolled in the Housing and Health Study. Using baseline data and controlling for gender, race, age, and education, we examined associations between self-reported two- and Seven-day adherence and access to healthcare, mental health, substance use, and attitudes toward HIV medical therapy. Of the 644 participants, 358 (55%) were currently on HAART. For two-day adherence, 280 (78%) reported missing no prescribed doses (100% adherence), and for seven-day adherence, 291 (81%) reported > or =90% adherence. Logistic regression analyses indicated being younger, not having health insurance, and drug use were associated with missing > or =1 dose over the past two days. Scoring lower on SF-36 mental component summary scale and having greater risk of depression (CES-D) and stress (Perceived Stress Scale) were associated with poorer adherence for both two- and seven-day outcomes. Negative attitudes toward HIV treatment were also associated with lower adherence. Adherence to HIV medications in this population is similar to other groups. Coexisting problems of access to healthcare, higher risk of mental health problems, along with poorer attitudes toward treatment are associated with increased likelihood of missing doses. Comprehensive models of HIV care that include a continuum of medical and social services are essential for treating this population.

Authors+Show Affiliations

Abt Associates Inc., Bethesda, MD, USA. scott_royal@abtassoc.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

19401865

Citation

Royal, Scott W., et al. "Factors Associated With Adherence to Highly Active Antiretroviral Therapy in Homeless or Unstably Housed Adults Living With HIV." AIDS Care, vol. 21, no. 4, 2009, pp. 448-55.
Royal SW, Kidder DP, Patrabansh S, et al. Factors associated with adherence to highly active antiretroviral therapy in homeless or unstably housed adults living with HIV. AIDS Care. 2009;21(4):448-55.
Royal, S. W., Kidder, D. P., Patrabansh, S., Wolitski, R. J., Holtgrave, D. R., Aidala, A., Pals, S., & Stall, R. (2009). Factors associated with adherence to highly active antiretroviral therapy in homeless or unstably housed adults living with HIV. AIDS Care, 21(4), 448-55. https://doi.org/10.1080/09540120802270250
Royal SW, et al. Factors Associated With Adherence to Highly Active Antiretroviral Therapy in Homeless or Unstably Housed Adults Living With HIV. AIDS Care. 2009;21(4):448-55. PubMed PMID: 19401865.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with adherence to highly active antiretroviral therapy in homeless or unstably housed adults living with HIV. AU - Royal,Scott W, AU - Kidder,Daniel P, AU - Patrabansh,Satyendra, AU - Wolitski,Richard J, AU - Holtgrave,David R, AU - Aidala,Angela, AU - Pals,Sherri, AU - Stall,Ron, PY - 2009/4/30/entrez PY - 2009/4/30/pubmed PY - 2009/7/1/medline SP - 448 EP - 55 JF - AIDS care JO - AIDS Care VL - 21 IS - 4 N2 - The aim of this study is to investigate adherence to highly active antiretroviral therapy (HAART) in persons living with HIV/AIDS (PLWHA) who are homeless or unstably housed. We evaluated homeless or unstably housed PLWHA (n=644) in three US cities were enrolled in the Housing and Health Study. Using baseline data and controlling for gender, race, age, and education, we examined associations between self-reported two- and Seven-day adherence and access to healthcare, mental health, substance use, and attitudes toward HIV medical therapy. Of the 644 participants, 358 (55%) were currently on HAART. For two-day adherence, 280 (78%) reported missing no prescribed doses (100% adherence), and for seven-day adherence, 291 (81%) reported > or =90% adherence. Logistic regression analyses indicated being younger, not having health insurance, and drug use were associated with missing > or =1 dose over the past two days. Scoring lower on SF-36 mental component summary scale and having greater risk of depression (CES-D) and stress (Perceived Stress Scale) were associated with poorer adherence for both two- and seven-day outcomes. Negative attitudes toward HIV treatment were also associated with lower adherence. Adherence to HIV medications in this population is similar to other groups. Coexisting problems of access to healthcare, higher risk of mental health problems, along with poorer attitudes toward treatment are associated with increased likelihood of missing doses. Comprehensive models of HIV care that include a continuum of medical and social services are essential for treating this population. SN - 1360-0451 UR - https://www.unboundmedicine.com/medline/citation/19401865/Factors_associated_with_adherence_to_highly_active_antiretroviral_therapy_in_homeless_or_unstably_housed_adults_living_with_HIV_ L2 - http://www.tandfonline.com/doi/full/10.1080/09540120802270250 DB - PRIME DP - Unbound Medicine ER -