Amsterdam 2015
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| Abstract #2030 - Treatment adherence | ||||
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Session: 48.1: Treatment adherence (Parallel) on Friday @ 09.00-10.30 in C002 Chaired by Kendra Blackett Dabinga, Aoife Molloy Authors: Presenting Author: Dr. Xiaoming Li - Wayne State University School of Medicine, United States |
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| Additional Authors: | ||||
| Aim: Background: The introduction of antiretroviral therapy (ART) has substantially reduced HIV/AIDS related morbidity and mortality. However, suboptimal adherence (i.e., taking less than 90-95% of prescribed doses) can diminish the benefits of treatment and result in severe personal and public health consequences. Existing studies have identified factors influencing ART adherence including demographic characteristics, psychiatric disorders, social support, and regimen complexity. But limited empirical studies focus on the role of emotional management in medicine adherence. In addition, the findings are mixed about the association between patients’ self-report ART adherence and their clinical outcomes (CD4, virus loading). Therefore, the current study aims to examine the relationships between clinical outcomes, mental health and medicine adherence among HIV patients in China. | ||||
| Method / Issue: Method: The data was collected by 6-month follow-up survey of a longitudinal randomized controlled trial initiated in 2013 among 796 HIV-positive parents (with at least one child aged 5-16 years) recruited from 42 HIV clinics across 12 cities/counties in Guangxi, China. A total of 447 participants receiving ART completed the survey including measures on demographics, mental health, and medicine adherence. The clinical outcomes were retrieved from medical records after consents. Participants were asked how many days they had taken ART medicine as prescribed in past 30 days. The ones whose answer =27 (taking at least 90% of prescribed does) were categorized as high adherence group, otherwise they were in low adherence group. Descriptive analysis and Generalized Linear Modeling (GLM) were employed in data analysis. | ||||
| Results / Comments: Results: The two groups were comparable in most of demographic characteristics. Compared to low adherence group, participants in high adherence group reported higher recent CD4 level, lower virus loading level, and lower emotional management difficulties scores. The multivariate test indicated significant associations between medicine adherence and clinical outcomes and emotional management (F=14.367, p<.001). Univariate tests suggested that medicine adherence was positively associated with CD4 level (F=18.353, p<.001), negatively associated with virus loading (F=24.903, p<.001), and negatively associated with emotional management difficulties (F=6.301, p=.012). | ||||
| Discussion: Discussion: Our findings confirm that self-reported ART adherence could be highly consistent with clinical outcomes among HIV patients in China. It is rarely explored but notable that emotional management problems may be a barrier to ART adherence for HIV patients. In the era when HIV/AIDS has been transforming from fatal disease to chronic one, emotional management could be a necessary component for patients’ self-management and self-care. | ||||
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