학술논문

Social Support Mitigates Negative Impact of Food Insecurity on Antiretroviral Adherence Among Postpartum Women in Western Kenya
Document Type
article
Source
AIDS and Behavior. 24(10)
Subject
Public Health
Health Sciences
Social Determinants of Health
Sexually Transmitted Infections
Infectious Diseases
Clinical Research
Behavioral and Social Science
HIV/AIDS
Zero Hunger
Adult
Anti-HIV Agents
Female
Food Supply
HIV Infections
Humans
Kenya
Medication Adherence
Postpartum Period
Quality of Life
Social Support
Socioeconomic Factors
Antiretroviral adherence
Hair ART drug concentrations
Food insecurity
Social support
Postpartum
Public Health and Health Services
Social Work
Public health
Language
Abstract
Food insecurity (FI), low social support, and low health-related quality of life (HRQoL) are associated with self-reported nonadherence to antiretroviral therapy (ART) among postpartum women, but these relationships have not been evaluated using objective adherence indicators. Hair samples were therefore analyzed among 83 postpartum Kenyan women living with HIV on efavirenz and nevirapine ART drug regimens in an observational cohort (NCT02974972). FI (0-27), social support (0-40), and HRQoL (8-40) in the prior month were also assessed. In multivariable models, each point increase in FI and decrease in HRQoL were associated with a 45.1% (95% CI: -64.3%, -15.6%) and 10.5% decrease (95% CI: 1.0%, 22.1%) in hair ART drug concentrations respectively, when social support was held constant. A significant interaction between social support and FI (β = 0.02, p = 0.017) indicated that greater social support was predicted to mitigate the negative impacts of FI on ART adherence. Addressing these modifiable barriers could improve ART adherence during this critical period.