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Gepubliceerd in: Journal of Behavioral Medicine 2/2021

24-10-2020

Trauma exposure, PTSD, and suboptimal HIV medication adherence among marginalized individuals connected to public HIV care in Miami

Auteurs: Tiffany R. Glynn, Noelle A. Mendez, Deborah L. Jones, Sannisha K. Dale, Adam W. Carrico, Daniel J. Feaster, Allan E. Rodriguez, Steven A. Safren

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 2/2021

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Abstract

Individuals living with HIV report disproportionately high levels of trauma exposure and PTSD symptoms, both which have been associated with suboptimal ART adherence. Often conflated, the question arises as to which construct is driving subsequent HIV self-care behavior. Given the HIV disparities among Black and Hispanic/Latinx individuals, and that Miami is a geographic region with a high racial/ethnic minority make up and a unique socioeconomic environment, it is important to explore factors related to HIV outcomes in Miami to mitigate its uncontrolled epidemic. This study aimed to examine the association of trauma exposure, PTSD symptoms, and relevant additional key factors with adherence to ART among a sample of majority Black and Hispanic/Latinx individuals who are economically marginalized receiving public HIV care in Miami, FL (N = 1237) via a cross-sectional survey. Sequential linear regression was used to examine the study aim in four blocks: (1) trauma, (2) PTSD symptoms, and key covariates of ART adherence including (3) depression and substance use (potential psychological covariates), and (4) indicators of socioeconomic status (potential structural covariates). In the first block, trauma exposure was associated with worse adherence. However, in the second block, the association with trauma dropped and PTSD was significantly associated with worse adherence. Of note, for those experiencing high levels of trauma exposure, adherence was negatively impacted regardless of PTSD. When other key factors associated with adherence were entered in the third and fourth blocks, neither trauma exposure nor PTSD were uniquely significant. In this final model, depression, substance use, and unstable housing were uniquely associated with worse adherence. Trauma-informed models of HIV care that holistically address co-occurring factors are warranted to cater to communities with HIV health disparities and keep them from falling off the HIV care continuum.
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Metagegevens
Titel
Trauma exposure, PTSD, and suboptimal HIV medication adherence among marginalized individuals connected to public HIV care in Miami
Auteurs
Tiffany R. Glynn
Noelle A. Mendez
Deborah L. Jones
Sannisha K. Dale
Adam W. Carrico
Daniel J. Feaster
Allan E. Rodriguez
Steven A. Safren
Publicatiedatum
24-10-2020
Uitgeverij
Springer US
Gepubliceerd in
Journal of Behavioral Medicine / Uitgave 2/2021
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI
https://doi.org/10.1007/s10865-020-00191-w