Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, Ontario.

Adult Anti-Retroviral Agents / therapeutic use Cohort Studies Cross-Sectional Studies Female HIV Infections / drug therapy Humans Logistic Models Medication Adherence / psychology Middle Aged Ontario / epidemiology Stress, Psychological / complications Surveys and Questionnaires
HIV Stress antiretroviral therapy depression women

Journal

HIV research & clinical practice
ISSN: 2578-7470
Titre abrégé: HIV Res Clin Pract
Pays: England
ID NLM: 101738312

Informations de publication

Date de publication:
Historique:
pubmed: 19 5 2020
medline: 29 5 2021
entrez: 19 5 2020
Statut: ppublish

Résumé

We aimed to identify the association between stress and antiretroviral therapy (ART) adherence among women in HIV care in Toronto, Ontario participating in the Ontario HIV Treatment Network Cohort Study (OCS) between 2007 and 2012. We conducted cross-sectional analyses with women on ART completing the AIDS Clinical Trial Group (ACTG) Adherence Questionnaire. Data closest to, or at the last completed interview, were collected from medical charts, through record linkage with Public Health Ontario Laboratories, and from a standardized self-reported questionnaire comprised of socio-demographic and psycho-socio-behavioral measures (Center for Epidemiologic Studies Depression Scale (CES-D), Alcohol Use Disorders Identification Test (AUDIT)), and stress measures (National Population Health Survey). Logistic regression was used to quantify associations with optimal adherence (≥95% adherence defined as missing ≤ one dose of ART in the past 4 weeks). Among 307 women, 65.5% had optimal adherence. Women with suboptimal compared to optimal adherence had higher median total stress scores (6.0 [interquartile range (IQR): 3.0-8.1] vs. 4.1 [IQR: 2.0-7.1], p = 0.001), CES-D scores (16 [IQR: 6-28] vs. 12 [IQR: 3-22], p = 0.008) and reports of hazardous and harmful alcohol use (31.1% vs. 17.9%, p = 0.008). In our multivariable model, we found an increased likelihood of optimal adherence with the absence of hazardous and harmful alcohol use (Adjusted Odds Ratio (AOR)=2.20, 95% confidence interval (CI): 1.12-4.32) and a decreased likelihood of optimal adherence with more self-reported stress (AOR = 0.56, 95% CI: 0.33-0.94). Interventions supporting optimal ART adherence should address stress and include strategies to reduce or eliminate hazardous and harmful alcohol use for women living with HIV.

Sections du résumé

BACKGROUND
We aimed to identify the association between stress and antiretroviral therapy (ART) adherence among women in HIV care in Toronto, Ontario participating in the Ontario HIV Treatment Network Cohort Study (OCS) between 2007 and 2012.
MATERIALS AND METHODS
We conducted cross-sectional analyses with women on ART completing the AIDS Clinical Trial Group (ACTG) Adherence Questionnaire. Data closest to, or at the last completed interview, were collected from medical charts, through record linkage with Public Health Ontario Laboratories, and from a standardized self-reported questionnaire comprised of socio-demographic and psycho-socio-behavioral measures (Center for Epidemiologic Studies Depression Scale (CES-D), Alcohol Use Disorders Identification Test (AUDIT)), and stress measures (National Population Health Survey). Logistic regression was used to quantify associations with optimal adherence (≥95% adherence defined as missing ≤ one dose of ART in the past 4 weeks).
RESULTS
Among 307 women, 65.5% had optimal adherence. Women with suboptimal compared to optimal adherence had higher median total stress scores (6.0 [interquartile range (IQR): 3.0-8.1] vs. 4.1 [IQR: 2.0-7.1], p = 0.001), CES-D scores (16 [IQR: 6-28] vs. 12 [IQR: 3-22], p = 0.008) and reports of hazardous and harmful alcohol use (31.1% vs. 17.9%, p = 0.008). In our multivariable model, we found an increased likelihood of optimal adherence with the absence of hazardous and harmful alcohol use (Adjusted Odds Ratio (AOR)=2.20, 95% confidence interval (CI): 1.12-4.32) and a decreased likelihood of optimal adherence with more self-reported stress (AOR = 0.56, 95% CI: 0.33-0.94).
CONCLUSIONS
Interventions supporting optimal ART adherence should address stress and include strategies to reduce or eliminate hazardous and harmful alcohol use for women living with HIV.

Identifiants

DOI: 10.1080/25787489.2020.1763711 PMID: 32419657
pubmed: 32419657
doi: 10.1080/25787489.2020.1763711
doi:

Substances chimiques

Anti-Retroviral Agents 0

Types de publication

Journal Article Multicenter Study Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

45-55

Subventions

Organisme : CIHR
Pays : Canada

Auteurs

Anita C Benoit (AC)

Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Ann N Burchell (AN)

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Department of Family and Community Medicine, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.

Kelly K O'Brien (KK)

Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
ORCID: 0000-0002-1632-6537

Janet Raboud (J)

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.

Sandra Gardner (S)

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Baycrest Health Sciences, Kunin-Lunenfeld Centre for Applied Research and Evaluation (KL-CARE), Toronto, ON, Canada.

Lucia Light (L)

Ontario HIV Treatment Network, Toronto, ON, Canada.

Kerrigan Beaver (K)

Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada.

Jasmine Cotnam (J)

Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada.

Tracey Conway (T)

Project Community Advisory Committee, Ontario HIV Treatment Network Cohort Study, Ontario, Canada.

Colleen Price (C)

Project Community Advisory Committee, Ontario HIV Treatment Network Cohort Study, Ontario, Canada.

Sean B Rourke (SB)

Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.

Sergio Rueda (S)

Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.

Trevor A Hart (TA)

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Department of Psychology, Ryerson University, Toronto, ON, Canada.
ORCID: 0000-0001-5107-7452

Mona Loutfy (M)

Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON, Canada.
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Medicine, Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Examining the association between stress and...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antiviraux › Antirétroviraux › Examining the association between stress and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Examining the association between stress and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études transversales › Examining the association between stress and...
questionsmedicales.fr › Maladies du système immunitaire › Déficits immunitaires › Infections à VIH › Examining the association between stress and...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Examining the association between stress and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de régression › Modèles logistiques › Examining the association between stress and...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Attitude envers la santé › Adhésion et observance thérapeutiques › Acceptation des soins par les patients › Observance par le patient › Adhésion au traitement médicamenteux › Examining the association between stress and...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Examining the association between stress and...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › Canada › Ontario › Examining the association between stress and...
questionsmedicales.fr › Phénomènes psychologiques › Stress psychologique › Examining the association between stress and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Examining the association between stress and...