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Examining adherence barriers among women with HIV to tailor outreach for long-acting injectable antiretroviral therapy.
BMC Womens Health. 2020 07 25; 20(1):152.BW

Abstract

BACKGROUND

Long-acting (LA) injectable antiretroviral therapy (ART) has been found non-inferior to daily oral ART in Phase 3 trials. LA ART may address key barriers to oral ART adherence and be preferable to daily pills for some people living with HIV. To date, women have been less represented than men in LA ART research. Using longitudinal data from the Women's Interagency HIV Study (WIHS) cohort of women living with HIV in the United States, we examined barriers and facilitators of daily oral ART adherence that may be related to or addressed by LA ART.

METHODS

We conducted a secondary analysis of WIHS cohort data from 1998 to 2017 among participants seen for at least 4 visits since 1998 who reported using ART at least once (n = 2601). Two dichotomous outcomes, patient-reported daily oral ART adherence and viral suppression were fit using generalized linear models, examining the role of socio-demographic and structural factors.

RESULTS

At study enrollment, the median age was 40.5 years, 63% of participants were African American and 22% were Latina. The majority (82%) reported taking ART more than 75% of the time and 53% were virally suppressed. In multivariate analysis, several sub-groups of women had lower odds of reported adherence and viral suppression: 1) younger women (adherence aOR: 0.71; viral suppression aOR: 0.63); 2) women who inject drugs (adherence aOR: 0.38; viral suppression aOR: 0.50) and those with moderate (adherence aOR: 0.59; viral suppression aOR: 0.74) and heavy alcohol consumption (adherence aOR: 0.51; viral suppression aOR: 0.69); 3) those with depressive symptoms (adherence aOR: 0.61; viral suppression aOR: 0.76); and 4) those with a history of going on and off ART (adherence aOR: 0.62, viral suppression aOR: 0.38) or changing regimens (adherence aOR: 0.83, viral suppression aOR: 0.56).

CONCLUSIONS

Current injectable contraceptive users (vs. non-users) had greater odds of oral ART adherence (aOR: 1.87) and viral suppression (aOR: 1.28). Findings identify profiles of women who may benefit from and be interested in LA ART. Further research is warranted focused on the uptake and utility of LA ART for such key subpopulations of women at high need for innovative approaches to achieve sustained viral suppression.

Authors+Show Affiliations

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Independent Consultant, New York, NY, USA. armantsios@gmail.com.Center for Health, Risk and Society, American University, Washington, DC, USA.Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, USA.Columbia University Mailman School of Public Health, Sociomedical Sciences, New York, USA.Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia.Department of Medicine, School of Medicine and Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.Department of Medicine, Stroger Hospital, Cook County Bureau of Health Services, Chicago, IL, USA.Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California, USA.Institute for Health Promotion and Disease Prevention Research, University of Southern California, Los Angeles, CA, USA.Division of Infectious Diseases and Travel Medicine, Georgetown University, Washington, DC, USA.SUNY Downstate Medical Center, Brooklyn, NY, USA.Independent Consultant, London, UK.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32711509

Citation

Benning, Lorie, et al. "Examining Adherence Barriers Among Women With HIV to Tailor Outreach for Long-acting Injectable Antiretroviral Therapy." BMC Women's Health, vol. 20, no. 1, 2020, p. 152.
Benning L, Mantsios A, Kerrigan D, et al. Examining adherence barriers among women with HIV to tailor outreach for long-acting injectable antiretroviral therapy. BMC Womens Health. 2020;20(1):152.
Benning, L., Mantsios, A., Kerrigan, D., Coleman, J. S., Golub, E., Blackstock, O., Konkle-Parker, D., Philbin, M., Sheth, A., Adimora, A. A., Cohen, M. H., Seidman, D., Milam, J., Kassaye, S. G., Taylor, T., & Murray, M. (2020). Examining adherence barriers among women with HIV to tailor outreach for long-acting injectable antiretroviral therapy. BMC Women's Health, 20(1), 152. https://doi.org/10.1186/s12905-020-01011-8
Benning L, et al. Examining Adherence Barriers Among Women With HIV to Tailor Outreach for Long-acting Injectable Antiretroviral Therapy. BMC Womens Health. 2020 07 25;20(1):152. PubMed PMID: 32711509.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Examining adherence barriers among women with HIV to tailor outreach for long-acting injectable antiretroviral therapy. AU - Benning,Lorie, AU - Mantsios,Andrea, AU - Kerrigan,Deanna, AU - Coleman,Jenell S, AU - Golub,Elizabeth, AU - Blackstock,Oni, AU - Konkle-Parker,Deborah, AU - Philbin,Morgan, AU - Sheth,Anandi, AU - Adimora,Adaora A, AU - Cohen,Mardge H, AU - Seidman,Dominika, AU - Milam,Joel, AU - Kassaye,Seble G, AU - Taylor,Tonya, AU - Murray,Miranda, Y1 - 2020/07/25/ PY - 2019/12/17/received PY - 2020/07/05/accepted PY - 2020/7/27/entrez PY - 2020/7/28/pubmed PY - 2020/12/30/medline KW - ART KW - Adherence KW - HIV KW - Long-acting injectable KW - Women SP - 152 EP - 152 JF - BMC women's health JO - BMC Womens Health VL - 20 IS - 1 N2 - BACKGROUND: Long-acting (LA) injectable antiretroviral therapy (ART) has been found non-inferior to daily oral ART in Phase 3 trials. LA ART may address key barriers to oral ART adherence and be preferable to daily pills for some people living with HIV. To date, women have been less represented than men in LA ART research. Using longitudinal data from the Women's Interagency HIV Study (WIHS) cohort of women living with HIV in the United States, we examined barriers and facilitators of daily oral ART adherence that may be related to or addressed by LA ART. METHODS: We conducted a secondary analysis of WIHS cohort data from 1998 to 2017 among participants seen for at least 4 visits since 1998 who reported using ART at least once (n = 2601). Two dichotomous outcomes, patient-reported daily oral ART adherence and viral suppression were fit using generalized linear models, examining the role of socio-demographic and structural factors. RESULTS: At study enrollment, the median age was 40.5 years, 63% of participants were African American and 22% were Latina. The majority (82%) reported taking ART more than 75% of the time and 53% were virally suppressed. In multivariate analysis, several sub-groups of women had lower odds of reported adherence and viral suppression: 1) younger women (adherence aOR: 0.71; viral suppression aOR: 0.63); 2) women who inject drugs (adherence aOR: 0.38; viral suppression aOR: 0.50) and those with moderate (adherence aOR: 0.59; viral suppression aOR: 0.74) and heavy alcohol consumption (adherence aOR: 0.51; viral suppression aOR: 0.69); 3) those with depressive symptoms (adherence aOR: 0.61; viral suppression aOR: 0.76); and 4) those with a history of going on and off ART (adherence aOR: 0.62, viral suppression aOR: 0.38) or changing regimens (adherence aOR: 0.83, viral suppression aOR: 0.56). CONCLUSIONS: Current injectable contraceptive users (vs. non-users) had greater odds of oral ART adherence (aOR: 1.87) and viral suppression (aOR: 1.28). Findings identify profiles of women who may benefit from and be interested in LA ART. Further research is warranted focused on the uptake and utility of LA ART for such key subpopulations of women at high need for innovative approaches to achieve sustained viral suppression. SN - 1472-6874 UR - https://www.unboundmedicine.com/medline/citation/32711509/Examining_adherence_barriers_among_women_with_HIV_to_tailor_outreach_for_long_acting_injectable_antiretroviral_therapy_ L2 - https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-020-01011-8 DB - PRIME DP - Unbound Medicine ER -