90-90-90-Plus: Maintaining Adherence to Antiretroviral Therapies

July 2017 - Biomedical Prevention

July 2017 Prevention Update (PDF, 400.76 KB)
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Corless, I.B., Hoyt, A.J., Tyer-Viola, L., et al., AIDS Patient Care and STDs (2017), 31(5): 227–236, doi: 10.1089/apc.2017.0009.

The authors of this study used 13 different psychosocial scales to predict self-reported medication adherence by 1,181 people in Canada, Namibia, Thailand, and the United States based upon various psychosocial characteristics including education, race, gender, ability to pay for health care, self-esteem, perceived stigma, depression, and anxiety. The authors categorized levels of adherence as high (>95%), moderate (61–94%), low (1–60%), and none (0%). The results showed that all but one scale (Berger’s Perceived Stigma Scale) were associated with the established levels of adherence. Nonwhites were twice as likely as whites to be in the none rather than the high adherence category. Adherence self-efficacy, depression, perceived stigma, and stressful life events all accurately predicted adherence. Clinicians should assess these factors to determine if specialized adherence interventions are required, the authors said. Education, gender, and capability to pay for health services did not accurately predict adherence. Those in the none adherence category demonstrated different psychosocial outcomes than individuals in other categories. Those in the low adherence category seemed to have access to treatment, but displayed challenges in medication adherence. The authors said that those in the moderate adherence category may benefit from additional education interventions; and those in the high adherence category should be congratulated and used to offer adherence support to their peers.

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