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01-08-2018 | Original Paper

Longitudinal Effects of Syndemics on ART Non-adherence Among Sexual Minority Men

Authors: Audrey Harkness, Sierra A. Bainter, Conall O’Cleirigh, Noelle A. Mendez, Kenneth H. Mayer, Steven A. Safren

Published in: AIDS and Behavior | Issue 8/2018

Abstract

This study examined longitudinally the additive effect of syndemics, or co-occurring psychosocial problems, on antiretroviral treatment (ART) non-adherence among 390 HIV-positive sexual minority men. Participants completed measures of ART adherence (reduced to a non-adherence score using exploratory factor analysis) and six syndemic conditions. We employed multilevel modeling with the number of syndemics as a longitudinal predictor of non-adherence, and logistic regression with baseline syndemics predicting follow up viral load. Number of syndemics was a significant longitudinal predictor of non-adherence, with each additional syndemic associated with a 0.13 increase in non-adherence (p = 0.004). Each additional syndemic was also associated with 1.27 greater odds of detectable viral load (p = 0.002). Among HIV-positive sexual minority men in this sample, more syndemics were associated with lower ART adherence and greater odds of detectable viral load, suggesting the need for behavioral intervention to facilitate care for this population.

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A sensitivity test using the log transformed non-adherence factor scores as the outcome variable revealed the same pattern of results as the original model. Syndemics remained a significant predictor of the log transformed non-adherence scores, γ = 0.03, SE = 0.01, t(513) = 0.002. Because the pattern of the results was unchanged, we retained the original factor score distribution with robust standard errors to increase interpretability of the findings.

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Title: Longitudinal Effects of Syndemics on ART Non-adherence Among Sexual Minority Men
Authors: Audrey Harkness
Sierra A. Bainter
Conall O’Cleirigh
Noelle A. Mendez
Kenneth H. Mayer
Steven A. Safren
Publication date: 01-08-2018
Publisher: Springer US
Published in: AIDS and Behavior / Issue 8/2018
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-018-2180-8

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