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J Acquir Immune Defic Syndr. 2019 Jan 1;80(1):103-109. doi: 10.1097/QAI.0000000000001878.

Predictors of Antiretroviral Adherence Self-efficacy Among People Living With HIV/AIDS in a Canadian Setting.

Author information

1
British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.
2
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
3
Department of Education Psychology and Leadership Studies, University of Victoria, Victoria, British Columbia, Canada.

Abstract

BACKGROUND:

Suboptimal adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) who use illicit drugs remains an ongoing health concern. Although health outcomes associated with adherence self-efficacy have been well-documented, there is dearth research exploring the predictors of this construct. This study sought to identify possible determinants of adherence self-efficacy among a cohort of PLWHA who use illicit drugs.

METHODS:

From December 2004 to May 2014, we collected data from the AIDS Care Cohort to evaluate Exposure to Survival Services, a prospective cohort of adult PLWHA who use illicit drugs in Vancouver, Canada. We used multivariate generalized estimating equation analyses to identify longitudinal factors independently associated with higher adherence self-efficacy.

RESULTS:

Among 742 participants, 493 (66.4%) identified as male and 406 (54.7%) reported white ancestry. In multivariate generalized estimating equation analysis, older age at ART initiation (adjusted odds ratio [AOR] = 1.02, 95% confidence interval [CI]: 1.00 to 1.03) and recent year of baseline interview (AOR = 1.08, 95% CI: 1.05 to 1.11) were independently associated with higher adherence self-efficacy, whereas homelessness (AOR = 0.78, 95% CI: 0.65 to 0.94), ‚Č•daily crack smoking (AOR = 0.81, 95% CI: 0.68 to 0.96), experienced violence (AOR = 0.82, 95% CI: 0.69 to 0.98), and childhood abuse (AOR = 0.75, 95% CI: 0.60 to 0.92) were negatively associated.

CONCLUSIONS:

These findings highlight the potential role that personal and contextual factors can play in predicting levels of ART adherence self-efficacy. Future research should seek to identify and validate strategies to optimize adherence self-efficacy.

PMID:
30300214
PMCID:
PMC6347383
[Available on 2020-01-01]
DOI:
10.1097/QAI.0000000000001878

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