Medication adherence challenges among HIV positive substance abusers

The role of food and housing insecurity

Dados Bibliográficos

ID19441663
AutoresHilary L Surratt (0000-0003-4027-7840, autor correspondente), Catherine O’Grady (Nova Southeastern University), Catherine L O'Grady, Maria A Levi-Minzi, Maria A Levi‐Minzi (Nova Southeastern University), Steven P Kurtz (0000-0002-4243-8129, Nova Southeastern University)
Ano2015
Volume27
Fascículo3
Páginas307-314
Data de publicação2015-03-04
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoAIDS Care (JOURNAL)
Identificadores do periódicoISSN: 0954-0121 • E-ISSN: 1360-0451
EditoraInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2014.967656
PMID25314042
PMCIDPMC4305452
OpenAlexW2028591581
IdiomaEN
Citações recebidas20
Referências citadas39

This study examines the prevalence of food/housing insecurity and its association with psychological, behavioral, and environmental factors impacting antiretroviral (ARV) medication adherence and diversion among substance using HIV+ patients in South Florida. Five hundred and three HIV+ substance abusers were recruited through targeted sampling. Participants completed a standardized instrument assessing demographics, mental health status, sex risk behaviors, HIV diagnosis, treatment history and access, ARV adherence and diversion, and attitudes toward health-care providers. Chi-square and t-tests were used to examine differences by food/housing status and a multivariate linear regression model examined food/housing insecurity and its associations to ARV adherence. Food/housing insecurity was reported by 43.3% of the sample and was associated with higher likelihood of severe psychological distress and substance dependence. Nearly 60% reported recent ARV diversion; only 47.2% achieved 95% medication adherence over one week. Food/housing insecure participants had deficits in their HIV care, including less time in consistent care, lower access to medical care, and less favorable attitudes toward care providers. Multivariate linear regression showed food/housing insecurity demonstrated significant main effects on adherence, including lower past week adherence. Medication diversion was also associated with reduced adherence. Our findings suggest that food/housing insecurity operates as a significant driver of ARV non-adherence and diversion in this population. In the pursuit of better long-term health outcomes for vulnerable HIV+ individuals, it is essential for providers to understand the role of food and housing insecurity as a stressor that negatively impacts ARV adherence and treatment access, while also significantly contributing to higher levels of distress and substance dependence

Environmental health · Food insecurity · Food security · Logistic regression · Mental health · Population · Psychiatry · Stressor · Substance abuse · Substance use · Food Security and Health in Diverse Populations · HIV/AIDS Research and Interventions · Homelessness and Social Issues · Medicine