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International Journal of Behavioral Medicine

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02-05-2022 | Mood Disorders | Full length manuscript

Life Instability Associated with Lower ART Adherence and Other Poor HIV-Related Care Outcomes in Older Adults with HIV

Authors: Elliott R. Weinstein, Audrey Harkness, Gail Ironson, Cho-Hee Shrader, Dustin T. Duncan, Steven A. Safren

Published in: International Journal of Behavioral Medicine | Issue 3/2023

Abstract

Background

Life instability may be an important factor for HIV-related care outcomes in older adults living with HIV (OALWH). This study examined the degree to which an 11-item life instability index (LII) composed of individual- and community-level indicators was associated with HIV-related care outcomes—viral load, antiretroviral (ART) medication adherence, rates of detectable viral load, and HIV care appointment non-adherence among OALWH in the Miami area.

Methods

Six hundred twenty-three OALWH completed an interviewer-administered assessment (English or Spanish), which was matched with medical record data.

Results

Participants reported about six LII indicators each (M = 6.08, SD = 1.44). Greater index scores were associated with worse self-reported ART adherence (b = − 1.14, p = 0.03), lower observed appointment adherence (b = 0.02, p < 0.01), higher viral load (b = 0.09, p = 0.02), and greater odds of viral detection (OR = 1.22, p = 0.01). Regarding health behaviors, life instability was significantly associated with increased illicit substance use among participants and not associated with depression or anxiety. The association of life instability to ART adherence remained significant (although attenuated) when controlling for the significant effects of substance use (b = − 0.40, BSTP [− 0.87, − 0.09]).

Conclusion

This present study is the first to examine an additive life instability index and its association with HIV-related behavioral and biomedical health outcomes among a population of OALWH. Greater indicators of life instability among OALWH may lead to poorer HIV-related health outcomes above and beyond the net of the effects of depression, anxiety, and substance use.

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Title: Life Instability Associated with Lower ART Adherence and Other Poor HIV-Related Care Outcomes in Older Adults with HIV
Authors: Elliott R. Weinstein
Audrey Harkness
Gail Ironson
Cho-Hee Shrader
Dustin T. Duncan
Steven A. Safren
Publication date: 02-05-2022
Publisher: Springer US
Keywords: Mood Disorders
Care
Human Immunodeficiency Virus
Affective Disorder
Anxiety
Published in: International Journal of Behavioral Medicine / Issue 3/2023
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-022-10095-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Life Instability Associated with Lower ART Adherence and Other Poor HIV-Related Care Outcomes in Older Adults with HIV

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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