Abstract
HIV + White, Latino, and African Americans (N = 1131) completed a survey advertised on social media to re-examine the effect of depressive symptoms (via the Patient Health Questionnaire; PHQ-9) and race/ethnicity on antiretroviral therapy nonadherence (defined as past 3-month, 4-day treatment interruption). An adjusted logistic regression showed a 15 % increase in odds for a treatment interruption per 1-unit increase on the PHQ-9. The effect of depressive symptoms on nonadherence was greater for Latinos (OR = 1.80, p < 0.05), but not for African Americans, compared to Whites. The benefits of modern ART (e.g., simpler, forgiving to minor lapses) may not circumvent the effect of depressive symptomatology.
References
Oh DL, Sarafian F, Silvestre A, et al. Evaluation of adherence and factors affecting adherence to combination antiretroviral therapy among White, Hispanic, and Black men in the MACS Cohort. J Acquir Immune Defic Syndr. 2009;52:290–300.
Simoni JM, Huh D, Wilson IB, et al. Racial/ethnic disparities in ART adherence in the United States: findings from the MACH14 Study. J Acquir Immune Defic Syndr. 2012;60:466–72.
Wagner GJ, Goggin K, Remien RH, et al. A closer look at depression and its relationship to HIV antiretroviral adherence. Ann Behav Med. 2011;42:352–60.
Gonzalez JS, Batchelder AW, Psaros C, Safren SA. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acquir Immune Defic Syndr. 2011;58:181–7.
Nachega JB, Mugavero MJ, Zeier M, Vitoria M, Gallant JE. Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs. Patient Prefer Adherence. 2011;5:357–67.
Parienti J-J, Paterson DL. Number of missed doses: why 1 × 7 does not make 7 × 1? AIDS. 2012;26:1437–40.
Maggiolo F, Ravasio L, Ripamonti D, et al. Similar adherence rates favor different virologic outcomes for patients treated with nonnucleoside analogues or protease inhibitors. Clin Infect Dis. 2005;40:158–63.
Bangsberg DR. Less than 95 % adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis. 2006;43:939–41.
Nelson M, Girard PM, Demasi R, et al. Suboptimal adherence to darunavir/ritonavir has minimal effect on efficacy compared with lopinavir/ritonavir in treatment-naive, HIV-infected patients: 96 week ARTEMIS data. J Antimicrob Chemother. 2010;65:1505–9.
Genberg BL, Wilson IB, Bangsberg DR, et al. Patterns of antiretroviral therapy adherence and impact on HIV RNA among patients in North America. AIDS. 2012;26:1415–23.
Parienti J-J, Das-Douglas M, Massari V, et al. Not all missed doses are the same: sustained NNRTI treatment interruptions predict HIV rebound at low-to-moderate adherence levels. PLoS ONE. 2008;3:e2783.
Parienti J, Ragland K, Lucht F, et al. Average adherence to boosted protease inhibitor therapy, rather than the pattern of missed doses, as a predictor of HIV RNA replication. Clin Infect Dis. 2010;15:1192–7.
Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res. 2014;16:e117.
Kalichman SC, Rompa D, Cage M. Reliability and validity of self-reported CD4 lymphocyte count and viral load test results in people living with HIV/AIDS. Int J STD AIDS. 2000;11:579–85.
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption—II. Addiction. 1993;88:791–804.
Carrico AW, Johnson MO, Morin SF, et al. Stimulant use is associated with immune activation and depleted tryptophan among HIV-positive persons on anti-retroviral therapy. Brain Behav Immun. 2008;22:1257–62.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.
Kalichman SC, Rompa D, Cage M. Distinguishing between overlapping somatic symptoms of depression and HIV disease in people living with HIV-AIDS. J Nerv Ment Dis. 2000;188:662–70.
Parienti JJ, Bangsberg DR, Verdon R, Gardner EM. Better adherence with once-daily antiretroviral regimens: a meta- analysis. Clin Infect Dis. 2009;48:484–8.
Dawson JF. Moderation in management research: what, why, when and how. J Bus Psychol. 2014;29:1–19.
Dawson JF. Two-way interactions. interpreting interaction effects. http://www.jeremydawson.co.uk/slopes.htm. Accessed 9 Oct 2014.
Carrico AW, Riley ED, Johnson MO, et al. Psychiatric risk factors for HIV disease progression: the role of inconsistent patterns of antiretroviral therapy utilization. J Acquir Immune Defic Syndr. 2011;56:146–50.
Alegría M, Mulvaney-Day N, Woo M, Torres M, Gao S, Oddo V. Correlates of past-year mental health service use among Latinos: results from the National Latino and Asian American Study. Am J Public Health. 2007;97:76–83.
Compton S, Haack S, Phillips CR. Identification of barriers to medication adherence in a Latino population. Res Soc Adm Pharm. 2010;6:365–71.
Dang BN, Giordano TP, Kim JH. Sociocultural and structural barriers to care among undocumented Latino immigrants with HIV Infection. J Immigr Minor Health. 2012;14:124–31.
Simoni JM, Kurth AE, Pearson CR, Pantalone DW, Merrill JO, Frick PA. Self-report measures of antiretroviral therapy adherence: a review with recommendations for HIV research and clinical management. AIDS Behav. 2006;10:227–45.
Acknowledgments
We are grateful to the participants in this study. The first author completed the manuscript with postdoctoral support by Grant T32 MH19105 and support to the second author was provided by K23 MH097649, both from the National Institute of Mental Health (NIMH) of the U.S. Public Health Service. Support to the third author was provided by K24 DA037034 and R01 MH102198 from the National Institute of Drug Abuse and the NIMH.
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Sauceda, J.A., Johnson, M.O. & Saberi, P. Nonadherence as 4-day Antiretroviral Therapy Interruptions: Do Depression and Race/Ethnicity Matter as Much in the Modern Antiretroviral Therapy Era?. AIDS Behav 20, 2624–2628 (2016). https://doi.org/10.1007/s10461-015-1283-8
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DOI: https://doi.org/10.1007/s10461-015-1283-8