학술논문

Exploring antiretroviral therapy adherence, competing needs, and viral suppression among people living with HIV and food insecurity in the Dominican Republic.
Document Type
Article
Source
AIDS Care. Oct2022, Vol. 34 Issue 10, p1234-1242. 9p. 3 Charts.
Subject
*PILOT projects
*SOCIAL support
*FOOD security
*VIRAL load
*ANTIRETROVIRAL agents
*RACE
*DRUGS
*DESCRIPTIVE statistics
*HEALTH insurance
*PATIENT compliance
*NEED (Psychology)
*ODDS ratio
*PSYCHOLOGY of HIV-positive persons
Language
ISSN
0954-0121
Abstract
Understanding factors related to suboptimal adherence to antiretroviral therapy (ART) and detectable viral load (VL), especially among vulnerable populations, is needed to improve HIV outcomes. The Caribbean is highly impacted by HIV and socioeconomic inequalities, but few studies have been conducted there to explore food insecurity among people with HIV and factors associated with viral suppression in this vulnerable population. Using baseline data from a pilot intervention trial among people living with HIV and food insecurity in the Dominican Republic, we examined psychosocial and behavioral factors associated with viral suppression, ART adherence, and competing needs. Among participants (n = 115), 61% had a detectable VL; the strongest factor associated with detectable VL was having missed taking ART in the last six months due to not having food (OR = 2.68, p = 0.02). Greater odds of reporting missed ART doses due to not having food were associated with severe food insecurity (OR = 4.60, p = 0.006), clinical depression (OR = 2.76, p = 0.018), Haitian background (OR = 6.62 p = 0.017), and internalized HIV stigma (OR = 1.09, p = 0.041), while lower odds were associated with social support (OR = 0.89, p = 0.03) and having health insurance (OR = 0.27, p = 0.017). Ensuring that people with HIV and food insecurity have food to take with their ART is essential for viral suppression. [ABSTRACT FROM AUTHOR]