Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 11/2016

01-11-2016 | Original Paper

Correlates of Combination Antiretroviral Adherence Among Recently Diagnosed Older HIV-Infected Adults Between 50 and 64 years

Authors: Winston E. Abara, Oluwatoyosi A. Adekeye, Junjun Xu, Harry J. Heiman, George Rust

Published in: AIDS and Behavior | Issue 11/2016

Login to get access

Abstract

Optimal adherence to combination antiretroviral therapy is essential to the health of older people living with HIV (PLWH), however, the literature on adherence and aging is limited. Using Medicaid data from 29 states (N = 5177), we explored correlates of optimal adherence among older PLWH. The prevalence of optimal adherence was low (32 %) in this study. Males were more adherent than females (APR = 1.11, 95 % CI 1.02–1.21, P = 0.0127); persons with three or more co-morbidities (APR = 0.67, 95 % CI 0.60–0.74, P < 0.001), two co-morbidities (APR = 0.86, 95 % CI 0.75–0.98, P = 0.0319) and one co-morbidity (APR = 0.82, 95 % CI 0.73–0.92, P = 0.0008) were less adherent than those without any co-morbidity; and residents of rural areas (APR = 0.90, 95 % CI 0.63–0.98, P = 0.0385) and small metropolitan areas (APR = 0.82, 95 % CI 0.72–0.94, P = 0.0032) were less adherent than residents of large metropolitan areas. There were no racial differences in optimal adherence. Targeted interventions that provide adherence support, case management, and peer navigation services may be of benefit in achieving optimal adherence in this population.
Literature
1.
2.
3.
Linley L, Prejean J, An Q, Chen M, Hall IH. Racial/ethnic disparities in HIV diagnoses among persons aged 50 years and older in 37 US States, 2005–2008. Am J Public Health. 2012;102(8):1527–34.PubMedPubMedCentralCrossRef
4.
Navarro G, Nogueras MM, Segura F, et al. HIV-1 infected patients older than 50 years. PISCIS cohort study. J Infect. 2008;57(1):64–71.PubMedCrossRef
5.
Perez JL, Moore RD. Greater effect of highly active antiretroviral therapy on survival in people aged ≥50 years compared with younger people in an urban observational cohort. Clin Infect Dis. 2003;36(2):212–8.PubMedCrossRef
6.
Grabar S, Weiss L, Costagliola D. HIV infection in older patients in the HAART era. J Antimicrob Chemo. 2006;57(1):4–7.CrossRef
7.
Abara WE, Smith L, Zhang S, Fairchild AJ, Heiman HJ, Rust G. The influence of race and comorbidity on the timely initiation of antiretroviral therapy among older persons living with HIV/AIDS. Am J Public Health. 2014;104(11):e135–41.PubMedPubMedCentralCrossRef
8.
Davis DH, Smith R, Brown A, Rice B, Yin Z, Delpech V. Early diagnosis and treatment of HIV infection: magnitude of benefit on short-term mortality is greatest in older adults. Age Ageing. 2013;42(4):520–6.PubMedPubMedCentralCrossRef
9.
Schick V, Herbenick D, Reece M, et al. Sexual behaviors, condom use, and sexual health of Americans over 50: implications for sexual health promotion for older adults. J Sexual Med. 2010;7(s5):315–29.CrossRef
10.
Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. New Eng J Med. 2007;357(8):762–74.PubMedPubMedCentralCrossRef
11.
Emlet CA. “You’re awfully old to have this disease”: experiences of stigma and ageism in adults 50 years and older living with HIV/AIDS. Gerontologist. 2007;46(6):781–90.CrossRef
12.
Emlet CA. A comparison of HIV stigma and disclosure patterns between older and younger adults living with HIV/AIDS. AIDS Patient Care STDS. 2006;20(5):350–8.PubMedCrossRef
13.
Skiest DJ, Rubinstien E, Carley N, Gioiella L, Lyons R. The importance of comorbidity in HIV-infected patients over 55: a retrospective case-control study. Am J Med. 1996;101(6):605–11.PubMedCrossRef
14.
Shah SS, McGowan JP, Smith C, Blum S, Klein RS. Comorbid conditions, treatment, and health maintenance in older persons with human immunodeficiency virus infection in New York City. Clin Infect Dis. 2002;35(10):1238–43.PubMedCrossRef
15.
Orlando G, Meraviglia P, Cordier L, et al. Antiretroviral treatment and age-related comorbidities in a cohort of older HIV-infected patients. HIV Med. 2006;7(8):549–57.PubMedCrossRef
16.
Johnson CJ, Heckman TG, Hansen NB, Kochman A, Sikkema KJ. Adherence to antiretroviral medication in older adults living with HIV/AIDS: a comparison of alternative models. AIDS Care. 2009;21(5):541–51.PubMedPubMedCentralCrossRef
17.
Cohen MS, Chen YQ, McCauley M, et al. HPTN 052 Study Team. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.PubMedPubMedCentralCrossRef
18.
Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373(9657):48–57.PubMedCrossRef
19.
Skarbinski J, Rosenberg E, Paz-Bailey G, et al. Human immunodeficiency virus transmission at each step of the care continuum in the United States. JAMA Intern Med. 2015;175(4):588–96.PubMedCrossRef
20.
Kong MC, Nahata MC, Lacombe VA, Seiber EE, Balkrishnan R. Association between race, depression, and antiretroviral therapy adherence in a low-income population with HIV infection. J Gen Intern Med. 2012;27(9):1159–64.PubMedPubMedCentralCrossRef
21.
Cohen CJ, Meyers JL, Davis KL. Association between daily antiretroviral pill burden and treatment adherence, hospitalization risk, and other healthcare utilization and costs in a US Medicaid population with HIV. BMJ Open. 2013;3(8):e003028.PubMedPubMedCentralCrossRef
22.
Sax PE, Meyers JL, Mugavero M, Davis KL. Adherence to antiretroviral treatment and correlation with risk of hospitalization among commercially insured HIV patients in the United States. PLoS One. 2012;7(2):e31591.PubMedPubMedCentralCrossRef
23.
Bottonari KA, Tripathi SP, Fortney JC, et al. Correlates of antiretroviral and antidepressant adherence among depressed HIV-infected patients. AIDS Patient Care STDs. 2012;26(5):265–73.PubMedCrossRef
24.
Kyser M, Buchacz K, Bush TJ, et al. Factors associated with non-adherence to antiretroviral therapy in the SUN study. AIDS Care. 2011;23(5):601–11.PubMedCrossRef
25.
Reynolds NR, Testa MA, Marc LG, et al. Factors influencing medication adherence beliefs and self-efficacy in persons naive to antiretroviral therapy: a multicenter, cross-sectional study. AIDS Behav. 2004;8(2):141–50.PubMedCrossRef
26.
Yun LW, Maravi M, Kobayashi JS, Barton PL, Davidson AJ. Antidepressant treatment improves adherence to antiretroviral therapy among depressed HIV-infected patients. J Acquir Immune Defic Syndr. 2005;38(4):432–8.PubMedCrossRef
27.
Hinkin CH, Hardy DJ, Mason KI, et al. Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS. 2004;18(S1):S19–25.PubMedPubMedCentralCrossRef
28.
Parsons JT, Starks TJ, Millar BM, Boonrai K, Marcotte D. Patterns of substance use among HIV-positive adults over 50: implications for treatment and medication adherence. Drug Alc Depend. 2014;2014(139):33–40.CrossRef
29.
Barclay TR, Hinkin CH, Castellon SA, et al. Age-associated predictors of medication adherence in HIV-positive adults: health beliefs, self-efficacy, and neurocognitive status. Health Psychol. 2007;26(1):40.PubMedPubMedCentralCrossRef
30.
Brañas F, Berenguer J, Sánchez-Conde M, et al. The eldest of older adults living with HIV: response and adherence to highly active antiretroviral therapy. Am J Med. 2008;21(9):820–4.CrossRef
31.
Bianco JA, Heckman TG, Sutton M, Watakakosol R, Lovejoy T. Predicting adherence to antiretroviral therapy in HIV-infected older adults: the moderating role of gender. AIDS Behav. 2011;15(7):1437–46.PubMedCrossRef
32.
Simone MJ, Appelbaum J. HIV in older adults. Geriatrics. 2008;63(12):6–12.PubMed
33.
34.
Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care. 1998;36(1):8–27.PubMedCrossRef
35.
Quan H, Sundararajan V, Halfon P, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005;43(11):1130–9.PubMedCrossRef
36.
Hess LM, Raebel MA, Conner DA, Malone DC. Measurement of adherence in pharmacy administrative databases: a proposal for standard definitions and preferred measures. Ann Pharmaco. 2006;40(7–8):1280–8.CrossRef
37.
Braithwaite RS, Kozal MJ, Chang CH, et al. Adherence, virological and immunological outcomes for HIV-infected veterans starting combination antiretroviral therapies. AIDS. 2007;21(12):1579–89.PubMedPubMedCentralCrossRef
38.
Ingersoll KS, Cohen J. The impact of medication regimen factors on adherence to chronic treatment: a review of literature. J Behav Med. 2008;31(3):213–24.PubMedPubMedCentralCrossRef
39.
Kong MC, Nahata MC, Lacombe VA, Seiber EE, Balkrishnan R. Association between race, depression, and antiretroviral therapy adherence in a low-income population with HIV infection. J Gen Intern Med. 2012;27(9):1159–64.PubMedPubMedCentralCrossRef
40.
Turner BJ, Laine C, Cosler L, Hauck WW. Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV-infected drug users. J Gen Intern Med. 2003;18(4):248–57.PubMedPubMedCentralCrossRef
41.
Pruitt Z, Robst J, Langland-Orban B, Brooks RG. Healthcare costs associated with antiretroviral adherence among Medicaid patients. App Health Econ Health Policy. 2014;13(1):69–80.CrossRef
42.
Puskas CM, Forrest JI, Parashar S, et al. Women and vulnerability to HAART non-adherence: a literature review of treatment adherence by gender from 2000 to 2011. Curr HIV/AIDS Rep. 2011;8(4):277–87.PubMedCrossRef
43.
Reif S, Golin CE, Smith SR. Barriers to accessing HIV/AIDS care in North Carolina: rural and urban differences. AIDS Care. 2005;17(5):558–65.PubMedCrossRef
44.
Cantudo-Cuenca MR, Jiménez-Galán R, Almeida-González CV, Morillo-Verdugo R. Concurrent use of comedications reduces adherence to antiretroviral therapy among HIV-infected patients. J Manag Care Pharm. 2014;20(8):844–50.
45.
Holtzman C, Armon C, Tedaldi E, et al. Polypharmacy and risk of antiretroviral drug interactions among the aging HIV-infected population. J Gen Intern Med. 2013;28(10):1302–10.PubMedPubMedCentralCrossRef
46.
47.
Monroe AK, Rowe TL, Moore RD, Chander G. Medication adherence in HIV-positive patients with diabetes or hypertension: a focus group study. BMC Health Serv Res. 2013;13(1):488.PubMedPubMedCentralCrossRef
48.
Saberi P, Dong BJ, Johnson MO, Greenblatt RM, Cocohoba JM. The impact of HIV clinical pharmacists on HIV treatment outcomes: a systematic review. Patient Prefer Adherence. 2012;6:297–322.PubMedPubMedCentralCrossRef
49.
Henderson KC, Hindman J, Johnson SC, Valuck RJ, Kiser JJ. Assessing the effectiveness of pharmacy-based adherence interventions on antiretroviral adherence in persons with HIV. AIDS Patient Care STDs. 2011;25(4):221–8.PubMedCrossRef
50.
Ma A, Chen DM, Chau FM, Saberi P. Improving adherence and clinical outcomes through an HIV pharmacist’s interventions. AIDS Care. 2010;22(10):1189–94.PubMedCrossRef
51.
Abara W, Heiman HJ. The Affordable Care Act and low-income people living with HIV: looking forward in 2014 and beyond. J Assoc Nurses AIDS Care: JANAC. 2014;25(6):476–82.PubMedPubMedCentralCrossRef
52.
Cahill SR, Mayer KH, Boswell SL. The Ryan White HIV/AIDS program in the age of health care reform. Am J Public Health. 2015;105(6):1078–85.PubMedCrossRef
53.
Bangsberg DR. Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis. 2006;43(7):939–41.PubMedCrossRef
Metadata
Title
Correlates of Combination Antiretroviral Adherence Among Recently Diagnosed Older HIV-Infected Adults Between 50 and 64 years
Authors
Winston E. Abara
Oluwatoyosi A. Adekeye
Junjun Xu
Harry J. Heiman
George Rust
Publication date
01-11-2016
Publisher
Springer US
Published in
AIDS and Behavior / Issue 11/2016
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-016-1325-x

Other articles of this Issue 11/2016

AIDS and Behavior 11/2016 Go to the issue

Original Paper

Does Adherence Change When No One is Looking? Comparing Announced and Unannounced Tenofovir Levels in a PrEP Trial

Brief Report

Nonadherence as 4-day Antiretroviral Therapy Interruptions: Do Depression and Race/Ethnicity Matter as Much in the Modern Antiretroviral Therapy Era?

Original Paper

Assessing Adherence to Antiretroviral Therapy in a Rural Paediatric Cohort in KwaZulu-Natal, South Africa

Original Paper

Female Partner Acceptance as a Predictor of Men’s Readiness to Undergo Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project

Original Paper

Anal Douche Practices and Willingness to Use a Rectal Microbicide Enema for HIV Prevention and Associated Factors Among an Internet Sample of HIV-Negative and HIV-Discordant Male Couples in the US

Original Paper

Progress Toward Eliminating Mother to Child Transmission of HIV in Kenya: Review of Treatment Guideline Uptake and Pediatric Transmission at Four Government Hospitals Between 2010 and 2012

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits