Examining adherence barriers among women with HIV to tailor outreach for long-acting injectable antiretroviral therapy.
BMC Womens Health
; 20(1): 152, 2020 07 25.
Article
em En
| MEDLINE
| ID: mdl-32711509
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Fármacos Anti-HIV
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Carga Viral
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Terapia Antirretroviral de Alta Atividade
/
Adesão à Medicação
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
BMC Womens Health
Assunto da revista:
SAUDE DA MULHER
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos