Sociodemographic and psychosocial predictors of longitudinal antiretroviral therapy (ART) adherence among first-time ART initiators in Cape Town, South Africa.

Journal: AIDS care

Volume: 33

Issue: 11

Year of Publication: 2021

Affiliated Institutions:  School of Social Work, Columbia University, New York, NY, USA. HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA. HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa. Numeracy Centre, Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa.

Abstract summary 

First-time antiretroviral therapy (ART) initiators may be more vulnerable to poor ART adherence because they may be coping with a new HIV diagnosis, facing logistical challenges to accessing and adhering to ART for the first time, and have not yet developed support networks or the skills to support long-term adherence. We recruited 324 participants in two HIV clinics near Cape Town, South Africa. Sociodemographic/psychosocial factors were measured at baseline and self-reported adherence at the 6 month follow-up. We conducted multivariable regression to determine which baseline factors were associated with 6-month adherence. A better patient-clinic relationship score (OR: 1.08 [95% CI: 1.05-1.11]) was associated with higher adherence. A drug use problem (0.51 [0.29-0.87]), higher social isolation (0.93 [0.87-0.99]), and greater number of years living with HIV before initiating ART (0.92 [0.86-1.00]) were associated with adherence levels below 90%. Patient-clinic relationships and social support are key psycho-social factors in early adherence behavior. Reducing drug use problems through targeted screening and early intervention may improve ART adherence.

Authors & Co-authors:  Davis Alissa A Pala Andrea Norcini AN Nguyen Nadia N Robbins Reuben N RN Joska John J Gouse Hetta H Mellins Claude A CA Myer Landon L Henry Michelle M Leu Cheng Shiun CS Remien Robert H RH

Study Outcome 

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Statistics
Citations :  Altice F, Mostashari F, & Friedland G (2001). Trust and the acceptance of and adherence to antiretroviral therapy. Journal of Acquired Immune Deficiency Syndrome, 28(1), pp. 47–58.
Authors :  11
Identifiers
Doi : 10.1080/09540121.2020.1798336
SSN : 1360-0451
Study Population
Male,Female
Mesh Terms
Anti-HIV Agents
Other Terms
Highly active antiretroviral therapy;medication adherence;social isolation;social support systems;substance abuse
Study Design
Longitudinal Study,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
England