Pills, PrEP, and Pals

Adherence, Stigma, Resilience, Faith and the Need to Connect Among Minority Women With HIV/Aids in a US HIV Epicenter

Bibliographic Data

ID22066760
AuthorsLunthita Duthely (0000-0002-9003-3257, University of Miami, corresponding author), Lunthita M Duthely, Alex P Sanchez-Covarrubias (0000-0002-0474-992X, University of Miami), Megan R Brown (0000-0003-3105-4688, University of Miami), Tanya Emmanuelle Thomas (0000-0001-6017-5636, University of Miami), Emily Montgomerie (0000-0001-8816-2300, University of Miami), Emily K Montgomerie, Sannisha K Dale (0000-0002-9516-239X, University of Miami), Sannisha Dale, Steven A Safren (0000-0002-0121-0806, University of Miami), Jonell E Potter, Jonell Potter (0000-0002-4620-2316, University of Miami)
Year2021
Volume9
Pages667331-667331
Publication date2021-06-21
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2021.667331
PMID34235129
OpenAlexW3173703524
LanguageEN
Citations received9
References cited37

Background: Ending HIV/AIDS in the United States requires tailored interventions. This study is part of a larger investigation to design mCARES, a mobile technology-based, adherence intervention for ethnic minority women with HIV (MWH). Objective: To understand barriers and facilitators of care adherence (treatment and appointment) for ethnic MWH; examine the relationship between these factors across three ethnic groups; and, explore the role of mobile technologies in care adherence. Methods: Cross-sectional, mixed-methods data were collected from a cohort of African-American, Hispanic-American and Haitian-American participants. Qualitative data were collected through a focus group ( n = 8) to assess barriers and facilitators to care adherence. Quantitative data ( n = 48) surveyed women on depressive symptomology (PHQ-9), HIV-related stigma (HSS) and resiliency (CD-RISC25). We examined the relationships between these factors and adherence to treatment and care and across groups. Findings: Qualitative analyses revealed that barriers to treatment and appointment adherence were caregiver-related stressors (25%) and structural issues (25%); routinization (30%) and religion/spirituality (30%) promoted adherence to treatment and care. Caregiver role was both a hindrance (25%) and promoter (20%) of adherence to treatment and appointments. Quantitatively, HIV-related stigma differed by ethnic group; Haitian-Americans endorsed the highest levels while African-Americans endorsed the lowest. Depression correlated to stigma ( R = 0.534; p < 0.001) and resiliency ( R = −0.486; p < 0.001). Across ethnic groups, higher depressive symptomology and stigma were related to viral non-suppression ( p < 0.05)—a treatment adherence marker; higher resiliency was related to viral suppression. Among Hispanic-Americans, viral non-suppression was related to depression ( p < 0.05), and among African-Americans, viral suppression was related to increased resiliency ( p < 0.04). Conclusion: Multiple interrelated barriers to adherence were identified. These findings on ethnic group-specific differences underscore the importance of implementing culturally-competent interventions. While privacy and confidentiality were of concern, participants suggested additional intervention features and endorsed the use of mCARES as a strategy to improve adherence to treatment and appointments

Ethnic group · Family medicine · Focus group · Pill · Psychiatry · Psychological intervention · Adolescent Sexual and Reproductive Health · Clinical Psychology · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Nursing · Gerontology

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