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Journal of Clinical Psychology in Medical Settings

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01-12-2016

HIV-Related Stress and Life Chaos Mediate the Association Between Poverty and Medication Adherence Among People Living with HIV/AIDS

Authors: Seth C. Kalichman, Moira O. Kalichman

Published in: Journal of Clinical Psychology in Medical Settings | Issue 4/2016

Abstract

HIV treatment depends on high-levels of antiretroviral therapy (ART) adherence, which is severely impeded by poverty. Men and women living with HIV infection (N = 92) completed computerized interviews of demographic and health characteristics, poverty markers, stressful life events, and life chaos, as well as unannounced pill counts to determine prospective medication adherence and medical record chart abstractions for HIV viral load. Poverty markers were associated with both stressors and chaos, and the direct effects of all three factors predicted ART non-adherence. The multiple mediation model showed that accounting for stressors and chaos resulted in a non-significant association between poverty markers and ART adherence. The indirect effect of poverty markers on adherence through life chaos was significant, whereas the indirect effect of poverty markers on adherence through stressors was not significant. Factors that render HIV-related stress and create chaos offer intervention targets that are more amenable to change than poverty itself.

Anema, A., Vogenthaler, N., Frongillo, E. A., Kadiyala, S., & Weiser, S. D. (2009). Food insecurity and HIV/AIDS: Current knowledge, gaps, and research priorities. Current HIV/AIDS Reports, 6(4), 224–231.CrossRefPubMed

Bangsberg, D. R., & Deeks, S. G. (2002). Is average adherence to HIV antiretroviral therapy enough? Journal of General Internal Medicine, 17(10), 812–813.CrossRefPubMedPubMedCentral

Bottonari, K. A., Roberts, J. E., Ciesla, J. A., & Hewitt, R. G. (2005). Life stress and adherence to antiretroviral therapy among HIV-positive individuals: A preliminary investigation. AIDS Patient Care and STDs, 19(11), 719–727.CrossRefPubMed

Bottonari, K. A., Safren, S. A., McQuaid, J. R., Hsiao, C. B., & Roberts, J. E. (2010). A longitudinal investigation of the impact of life stress on HIV treatment adherence. Journal of Behavioral Medicine, 33(6), 486–495.CrossRefPubMedPubMedCentral

Braithwaite, R. S., McGinnis, K., Conigliaro, J., Maisto, S. A., Crystal, S., Day, N., … Justice, A. (2005). A temporal and dose-response association between alcohol consumption and medication adherence among veterans in care. Alcoholism, Clinical and Experimental Research, 29, 190–197.

Carrieri, M. P., Villes, V., Raffi, F., Protopopescu, C., Preau, M., Salmon, D., … APROCO-COPILOTE COHORT ANRS CO-8 Study Group. (2007). Self-reported side-effects of anti-retroviral treatment among IDUs: A 7-year longitudinal study (APROCO-COPILOTE COHORT ANRS CO-8). International Journal of Drug Policy, 18(4), 288–295.CrossRefPubMed

Chesney, M., Folkman, S., & Chambers, D. (1996). Coping effectiveness training for men living with HIV: Preliminary findings. International Journal of STD and AIDS, 7(Suppl 2), 75–82.CrossRefPubMed

Dejesus, E., Young, B., Morales-Ramirez, J. O., Sloan, L., Ward, D. J., Flaherty, J. F., & Farajallah, A. (2009). Simplification of antiretroviral therapy to a single-tablet regimen consisting of efavirenz, emtricitabine, and tenofovir disoproxil fumarate versus unmodified antiretroviral therapy in virologically suppressed HIV-1-infected patients. Journal of Acquired Immune Deficiency Syndromes, 51(2), 163–174.CrossRefPubMed

DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology, 23(2), 207–218.CrossRefPubMed

Evans, G. W., Gonnella, C., Marcynyszyn, L. A., Gentile, L., & Salpekar, N. (2005). The role of chaos in poverty and children’s socioemotional adjustment. Psychological Sciences, 16(7), 560–565.CrossRef

Faramawi, M. F., Johnson, E., Fry, M. W., Sall, M., & Zhou, Y. (2007). Consumption of different types of meat and the risk of renal cancer: Meta-analysis of case-control studies. Cancer Causes and Control, 18(2), 125–133.CrossRefPubMed

Georgia Department of Public Health. (2013). HIV/AIDS Surveillance Report. Retrieved June 20, 2016, from https://dph.georgia.gov/georgias-hivaids-epidemiology-surveillance-section.

Groleau, V., Herold, R. A., Schall, J. I., Wagner, J. L., Dougherty, K. A., Zemel, B. S., & Stallings, V. A. (2013). Blood lead concentration is not altered by high-dose vitamin D supplementation in children and young adults with HIV. Journal of Pediatric Gastroenterology and Nutrition 56(3), 316–319.CrossRefPubMedPubMedCentral

Haberer, J. E., Robbins, G. K., Ybarra, M., Monk, A., Ragland, K., Weiser, S. D., … Bangsberg, D. R. (2011). Real-time electronic adherence monitoring is feasible, comparable to unannounced pill counts, and acceptable. AIDS and Behavior, 16(2), 375–382.

Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling. Retrieved from http://www.afhayes.com/public/process2012.pdf.

Ivers, L. C., Cullen, K. A., Freedberg, K. A., Block, S., Coates, J., & Webb, P. (2009). HIV/AIDS, undernutrition, and food insecurity. Clinical Infectious Diseases, 49(7), 1096–1102.CrossRefPubMedPubMedCentral

Johnson, M. O., & Neilands, T. B. (2007). Coping with HIV treatment side effects: Conceptualization, measurement, and linkages. AIDS and Behavior, 11(4), 575–585.CrossRefPubMedPubMedCentral

Kalichman, S. C., Amaral, C. M., Cherry, C., Flanagan, J. A., Pope, H., Eaton, L., … Schinazi, R. (2008). Monitoring Antiretroviral adherence by unannounced pill counts conducted by telephone: Reliability and criterion-related validity. HIV Clinical Trials, 9, 298–308.

Kalichman, S. C., Amaral, C., Swetsze, C., Eaton, L., Kalichman, M. O., Cherry, C., … Schinazi, R. F. (2010). Monthly unannounced pill counts for monitoring HIV treatment adherence: Tests for self-monitoring and reactivity effects. HIV Clinical Trials, 11(6), 325–331.

Kalichman, S. C., DiMarco, M., Austin, J., Luke, W., & DiFonzo, K. (2003). Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women. Journal of Behavioral Medicine, 26(4), 315–332.CrossRefPubMed

Kalichman, S. C., Hernandez, D., Cherry, C., Kalichman, M. O., Washington, C., & Grebler, T. (2014). Food insecurity and other poverty indicators among people living with HIV/AIDS: Effects on treatment and health outcomes. Journal of Community Health, 39(6), 1133–1139.CrossRefPubMedPubMedCentral

Kalichman, S. C., Rompa, D., & Cage, M. (2000). Distinguishing between overlapping somatic symptoms of depression and HIV disease in people living with HIV-AIDS. Journal of Nervous and Mental Disorders, 188(10), 662–670.CrossRef

Kalichman, S. C., Washington, C., Grebler, T., Hoyt, G., Welles, B., Kegler, C., … Cherry, C. (2015). Medication adherence and health outcomes of people living with HIV who are food insecure and prescribed antiretrovirals that should be taken with food. Infectious Disease Therapy. doi:10.1007/s40121-015-0057-y.

Kalichman, S. C., Washington, C., Grebler, T., Hoyt, G., Welles, B., Merely, C., … Cherry, C. (2015). Treatment outcomes among people living with HIV who are food insecure and prescribed antiretrovirals taken with food. Journal of Primary Care and Community Health, 6(1), 35–40.

Leaver, C. A., Bargh, G., Dunn, J. R., & Hwang, S. W. (2007). The effects of housing status on health-related outcomes in people living with HIV: A systematic review of the literature. AIDS and Behavior, 11(6 Suppl), 85–100.CrossRefPubMed

Leserman, J., Ironson, G., O’Cleirigh, C., Fordiani, J. M., & Balbin, E. (2008). Stressful life events and adherence in HIV. AIDS Patient Care and STDs, 22(5), 403–411.CrossRefPubMedPubMedCentral

Lima, V. D., Bangsberg, D. R., Harrigan, P. R., Deeks, S. G., Yip, B., Hogg, R. S., & Montaner, J. S. (2010). Risk of viral failure declines with duration of suppression on highly active antiretroviral therapy irrespective of adherence level. Journal of Acquired Immune Deficiency Syndromes, 55(4), 460–465.CrossRefPubMedPubMedCentral

Maisto, S. A., Conigliaro, J., McNeil, M., Kraemer, K., & Kelley, M. E. (2000). An empirical investigation of the factor structure of the AUDIT. Psychological Assessment, 12(3), 346–353.CrossRefPubMed

Matheny, A., Wachs, T., Ludwig, J., & Phillips, K. (1995). Bringing order out of chaos: Psychometric characteristics of the confusion, Hubbub, and Order Scale. Journal of Applied Developmental Psychology, 16, 429–444.CrossRef

McManus, H., O’Connor, C. C., Boyd, M., Broom, J., Russell, D., Watson, K., … Australian, H. I. V. O. D. (2012). Long-term survival in HIV positive patients with up to 15 years of antiretroviral therapy. PLoS ONE, 7(11), e48839.

Morrison-Beedy, D., Carey, M. P., & Tu, X. (2006). Accuracy of audio computer-assisted self-interviewing (ACASI) and self-administered questionnaires for the assessment of sexual behavior. AIDS and Behavior, 10(5), 541–552.CrossRefPubMedPubMedCentral

Mugavero, M. J., Raper, J. L., Reif, S., Whetten, K., Leserman, J., Thielman, N. M., & Pence, B. W. (2009). Overload: Impact of incident stressful events on antiretroviral medication adherence and virologic failure in a longitudinal, multisite human immunodeficiency virus cohort study. Psychosomatic Medicine, 71(9), 920–926.CrossRefPubMedPubMedCentral

Ortego, C., Huedo-Medina, T. B., Llorca, J., Sevilla, L., Santos, P., Rodriguez, E., … Vejo, J. (2011). Adherence to highly active antiretroviral therapy (HAART): A meta-analysis. AIDS and Behavior, 15(7), 1381–1396.

Parienti, J. J., Bangsberg, D. R., Verdon, R., & Gardner, E. M. (2009). Better adherence with once-daily antiretroviral regimens: A meta-analysis. Clinical Infectious Diseases, 48(4), 484–488.CrossRefPubMedPubMedCentral

Parienti, J. J., Barrail-Tran, A., Duval, X., Nembot, G., Descamps, D., Vigan, M., … Goujard, C. (2013). Adherence profiles and therapeutic responses of treatment-naive HIV-infected patients starting boosted atazanavir-based therapy in the ANRS 134-COPHAR 3 trial. Antimicrobial Agents and Chemotherapy, 57(5), 2265–2271.

Pellowski, J. A., Kalichman, S. C., Matthews, K. A., & Adler, N. (2013). A pandemic of the poor: Social disadvantage and the U.S. HIV epidemic. American Psychologist, 68(4), 197–209.CrossRefPubMedPubMedCentral

Petersen, M. L., Wang, Y., van der Laan, M. J., Guzman, D., Riley, E., & Bangsberg, D. R. (2007). Pillbox organizers are associated with improved adherence to HIV antiretroviral therapy and viral suppression: A marginal structural model analysis. Clinical Infectious Diseases, 45(7), 908–915.CrossRefPubMedPubMedCentral

Preacher, K. J., Rucker, D., & Hayes, A. (2007). Addressing moderated mediation hypotheses: Theory, methods, and prescriptions. Multivariate Behavioral Research, 42, 185–227.CrossRefPubMed

Scott-Sheldon, L. A., Kalichman, S. C., Carey, M. P., & Fielder, R. L. (2008). Stress management interventions for HIV+ adults: A meta-analysis of randomized controlled trials, 1989 to 2006. Health Psychology, 27(2), 129–139.CrossRefPubMedPubMedCentral

Smolderen, K. G., & Whooley, M. A. (2013). Psychological distress and medication adherence: Creating order out of chaos? Circulation and Cardiovascular Quality Outcomes, 6(6), 615–616.CrossRef

Surratt, H. L., O’Grady, C. L., Levi-Minzi, M. A., & Kurtz, S. P. (2015). Medication adherence challenges among HIV positive substance abusers: The role of food and housing insecurity. AIDS Care, 27(3), 307–314.CrossRefPubMed

Tuller, D. M., Bangsberg, D. R., Senkungu, J., Ware, N. C., Emenyonu, N., & Weiser, S. D. (2009). Transportation costs impede sustained adherence and access to HAART in a clinic population in Southwestern Uganda: A qualitative study. AIDS and Behavior, 14(4), 778–784.CrossRefPubMedPubMedCentral

Van Dam, N. T., & Earleywine, M. (2011). Validation of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R): Pragmatic depression assessment in the general population. Psychiatry Research, 186(1), 128–132.CrossRefPubMed

van der Sande, M. A., Schim van der Loeff, M. F., Aveika, A. A., Sabally, S., Togun, T., Sarge-Njie, R., & Whittle, H. C. (2004). Body mass index at time of HIV diagnosis: A strong and independent predictor of survival. Journal of Acquired Immune Deficiency Syndromes, 37(2), 1288–1294.CrossRefPubMed

Wagner, G. J., & Ryan, G. W. (2004). Relationship between routinization of daily behaviors and medication adherence in HIV-positive drug users. AIDS Patient Care and STDs, 18(7), 385–393.CrossRefPubMed

Weiser, S. D., Hatcher, A., Frongillo, E. A., Guzman, D., Riley, E. D., Bangsberg, D. R., & Kushel, M. B. (2012). Food insecurity is associated with greater acute care utilization among HIV-infected homeless and marginally housed individuals in San Francisco. Journal of General Internal Medicine, 28(1), 91–98.CrossRefPubMedPubMedCentral

Welty, T. E., Willis, S. L., & Welty, E. A. (2010). Effect of limited transportation on medication adherence in patients with epilepsy. Journal of the American Pharmacists Association, 50(6), 698–703.CrossRefPubMed

Wong, M. D., Sarkisian, C. A., Davis, C., Kinsler, J., & Cunningham, W. E. (2007). The association between life chaos, health care use, and health status among HIV-infected persons. Journal of General Internal Medicine, 22(9), 1286–1291.CrossRefPubMedPubMedCentral

Zullig, L. L., Shaw, R. J., Crowley, M. J., Lindquist, J., Grambow, S. C., Peterson, E., & Bosworth, H. B. (2013). Association between perceived life chaos and medication adherence in a postmyocardial infarction population. Circulation and Cardiovascular Quality Outcomes, 6(6), 619–625.CrossRef

Title: HIV-Related Stress and Life Chaos Mediate the Association Between Poverty and Medication Adherence Among People Living with HIV/AIDS
Authors: Seth C. Kalichman
Moira O. Kalichman
Publication date: 01-12-2016
Publisher: Springer US
Published in: Journal of Clinical Psychology in Medical Settings / Issue 4/2016
Print ISSN: 1068-9583
Electronic ISSN: 1573-3572
DOI: https://doi.org/10.1007/s10880-016-9481-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

HIV-Related Stress and Life Chaos Mediate the Association Between Poverty and Medication Adherence Among People Living with HIV/AIDS

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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