Perceptions About Local ART Adherence Norms and Personal Adherence Behavior Among Adults Living with HIV in Rural Uganda.

Autor: Perkins JM; Peabody College, Vanderbilt University, PMB 90, 230 Appleton Place, Nashville, TN, 37203-5721, USA. jessica.m.perkins@vanderbilt.edu.; Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, TN, USA. jessica.m.perkins@vanderbilt.edu., Kakuhikire B; Mbarara University of Science and Technology, Mbarara, Uganda., Baguma C; Mbarara University of Science and Technology, Mbarara, Uganda., Rasmussen JD; Duke University, Durham, NC, USA., Satinsky EN; Center for Global Health, Massachusetts General Hospital, Boston, MA, USA., Kiconco A; Mbarara University of Science and Technology, Mbarara, Uganda., Kananura J; Mbarara University of Science and Technology, Mbarara, Uganda., Audet CM; Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, TN, USA.; University of Witwatersrand, Johannesburg, South Africa., Siedner MJ; Center for Global Health, Massachusetts General Hospital, Boston, MA, USA.; Division of Infectious Diseases and Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Mongan Institute, Massachusetts General Hospital, Boston, MA, USA., Haberer JE; Center for Global Health, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Bangsberg DR; Mbarara University of Science and Technology, Mbarara, Uganda.; Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA., Tsai AC; Mbarara University of Science and Technology, Mbarara, Uganda.; Center for Global Health, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2022 Jun; Vol. 26 (6), pp. 1892-1904. Date of Electronic Publication: 2022 Jan 16.
DOI: 10.1007/s10461-021-03540-1
Abstrakt: Although misperceived norms often drive personal health behaviors, we do not know about this phenomenon in the context of antiretroviral therapy (ART) adherence. We conducted a cross-sectional study including all persons living with HIV (PLWH) on ART across eight villages in one parish in a rural region of southwestern Uganda. We used surveys to measure personal reports of ART adherence (not missing any doses of ART in the past 7 days was considered optimal adherence whereas missing doses was considered suboptimal adherence) and perceived norms about the local ART adherence norm (whether or not each individual thought 'most other PLWH on ART in this parish' missed any doses in the past 7 days). Multivariable Poisson regression models were used to estimate the association between perceived norms and personal adherence. Among 159 PLWH on ART (95% response rate), 142 (89%) reported no missed doses. However, 119 (75%) thought most individuals in this population of PLWH on ART were sub-optimally adherent. This misperception about the local ART adherence norm was prevalent in every subgroup of PLWH. Misperceiving the local ART adherence norm to be sub-optimal adherence was associated with a reduced likelihood of optimal adherence among married PLWH (adjusted relative risk [aRR] = 0.83; 95% confidence interval [CI] 0.71-0.97). The association was similar but imprecisely estimated for all PLWH (aRR = 0.91; 95% CI 0.82-1.01). Interventions to correct misperceived ART adherence norms as a stand-alone intervention or as a complement to other adherence promotion programs may influence ART adherence behavior and perhaps reduce HIV-related stigma.
(© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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