Correlates of and barriers to ART adherence among adherence-challenged people living with HIV in southern India
| Autor: | B N Ravi Kumar, Ranjani Shamsundar, Sara Chandy, Elsa Heylen, Shoba Nair, Maria L. Ekstrand |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Health (social science) Social Psychology Social Stigma Human immunodeficiency virus (HIV) Psychological intervention India Stigma (botany) HIV Infections medicine.disease_cause Article Medication Adherence 03 medical and health sciences 0302 clinical medicine Effective interventions Antiretroviral Therapy Highly Active medicine Humans 030212 general & internal medicine 030505 public health Community level Depression business.industry Public Health Environmental and Occupational Health Social Support Fear Middle Aged Antiretroviral therapy Art adherence Regimen Cross-Sectional Studies Family medicine Quality of Life Female 0305 other medical science business |
| Zdroj: | AIDS Care |
| ISSN: | 1360-0451 0954-0121 |
| Popis: | Suboptimal adherence to Antiretroviral Therapy (ART) regimens can lead to the development of drug resistance, virologic and clinical failure, and, on the community level, the spread of drug-resistant HIV. To design effective interventions, it is crucial to understand locally specific barriers to optimal adherence. Self-report data from a cross-sectional sample of 527 adherence-challenged people living with HIV (PLWH) in the South-Indian state of Karnataka showed that they took on average 68% of prescribed doses in the past month. Large majorities of participants encountered individual (95%), social/structural (88%), and clinic/regimen (80%) adherence barriers. Multivariate linear regression analyses of past month adherence showed that disclosure to all adults in the household was positively related to adherence, as was employing a larger number of adherence strategies, perceiving more benefits of ART, and having been on ART for longer. Fears of stigmatization upon disclosure of HIV-status to friends and people at work were negatively related to adherence. These results suggest that some barriers, especially individual-level barriers like forgetfulness are very common and can be targeted with relatively simple individual-level strategies. Other barriers, related to fear of stigma and lack of disclosure may require family- or community-level interventions. |
| Databáze: | OpenAIRE |
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