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
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 5/2007

01-09-2007 | Original Paper

Medication Adherence and Sexual Risk Behavior among HIV-Infected Adults: Implications for Transmission of Resistant Virus

Authors: Robert H. Remien, Theresa M. Exner, Stephen F. Morin, Anke A. Ehrhardt, Mallory O. Johnson, Jackie Correale, Stephanie Marhefka, Sheri B. Kirshenbaum, Lance S. Weinhardt, Mary Jane Rotheram-Borus, Sheryl L. Catz, Cheryl Gore-Felton, Margaret A. Chesney, Jeffrey Kelly, The NIMH Healthy Living Project Team

Published in: AIDS and Behavior | Issue 5/2007

Login to get access

Abstract

As more people are living long-term with HIV there are growing concerns about specific behaviors that can affect both personal and the public health. This study examined the relationship between antiretroviral therapy (ART) adherence and sexual risk behavior and their association with psychosocial and health factors among a diverse sample of 2,849 HIV-infected adults. Only 8.5% of the sample reported both non-adherence and sexual risk. Individuals were 46% more likely to report one of these risk outcomes when the other one was present and the presence of both outcomes was associated with an increased likelihood of having a detectable viral load. A simultaneous polytomous regression analysis revealed complex relationships among a range of psychosocial variables and the two primary behavioral risk outcomes. There is a need for targeted interventions and integration of mental health and substance use services into primary HIV care settings.
Literature
Aloisi, M. S., Arici, C., Balzano, R., Noto, P., Piscopo, R., Filice, G., Menichetti, F., d’Arminio Monforte, A., Ippolito, G., Girardi, E., & Italian Cohort Naive Antiretrovirals Behavioral Epidemiology Study Group. (2002). Behavioral correlates of adherence to antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes, 31, 145–148.
Bangsberg, D. R., Porco, T. C., Kagay, C., Charlebois, E. D., Deeks, S. G., Guzman, D., Clark, R., & Moss, A. (2004). Modeling the HIV protease inhibitor adherence–resistance curve by use of empirically derived estimates. Journal of Infectious Diseases, 190, 162–165.CrossRefPubMed
Beck, A. T. (1967). Depression: Clinical, experimental and theoretical aspects. Philadelphia: University of Pennsylvania Press.
Bing, E. G., Burnam, M. A., Longshore, D., et al. (2001). Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Archives of General Psychiatry, 58, 721–728.CrossRefPubMed
Blower, S. M., Aschenbach, A. N., Gershengorn, H. B., & Kahn, J. O. (2001). Predicting the unpredictable: Transmission of drug-resistant HIV. Nature Medicine, 1, 1016–1020.CrossRef
Blower, S. M., Aschenbach, A. N., & Kahn, J. O. (2003). Predicting the transmission of drug-resistant HIV: Comparing theory with data. Lancet Infectious Diseases, 3, 10–11.CrossRefPubMed
Boarts, J. M., Sledjeski, E. M., Bogart, L. M., & Delahanty, D. L. (2006). The differential impact of PTSD and depression on HIV disease markers and adherence to HAART in people living with HIV. AIDS and Behavior, 10, 253–261.CrossRefPubMed
Bottanari, 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, 719–727.CrossRef
Centers for Disease Control and Prevention. (2005). Trends in HIV diagnoses—33 states, 2001–2004. Morbidity and Mortality Weekly Report, 54, 1149–1153.
Chesney, M. A., Folkman, S., & Chambers, D. (1996). Coping effectiveness training for men living with HIV: Preliminary findings. International Journal of STD & AIDS, 7, 75–82.CrossRef
Chesney, M. A., Ickovics, J. R., Chambers, D. B., Gifford, A. L., Neidig, J., Zwickl, B., & Wu, A. W. (2000). Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The AACTG adherence instruments. AIDS Care, 12, 255–266.CrossRefPubMed
Chin-Hong, P. V., Deeks, S. G., Liegler, T., Hagos, E., Krone, M. R., Grant, R. M., & Martin, J. N. (2005). High risk sexual behavior in adults with genotypically proven antiretroviral-resistant HIV infection. Journal of Acquired Immune Deficiency Syndromes, 40, 463–471.CrossRefPubMed
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.CrossRefPubMed
Cohen, S., & Williamson, G. M. (1988). Perceived stress in a probability sample in the US. In S. Spacapan, & S. Oskamp (Eds.), The social psychology of health (pp.31–67). CA: Sage.
Cox, J., Beauchemin, J., & Allard, R. (2004). HIV status of sexual partners is more important than antiretroviral treatment related perceptions for risk taking by HIV positive MSM in Montreal, Canada. Sexually Transmitted Diseases, 80, 518–523.
Crepaz, N., Hart, T. A., & Marks, G. (2004). Highly active antiretroviral therapy and sexual risk behavior. Journal of American Medical Association, 292, 224–236.CrossRef
Cutrona, C.E. (1989). Ratings of social support by adolescents and adult informants: Degree of correspondence and prediction of depressive symptoms. Journal of Personality and Social Psychology, 57, 723–730.CrossRefPubMed
Denning, P. H., & Campsmith, M. L. (2005). Unprotected anal intercourse among HIV- positive men who have a steady male sex partner with negative or unknown HIV serostatus. American Journal of Public Health, 95, 152–158.CrossRefPubMed
Ehrhardt, A. A., Exner, T. M., Hoffman, S., Silberman, I., Yingling, S., Adams-Skinner, J., & Smart-Smith, L. (2002). HIV/STD risk and sexual strategies among women family planning clients in New York: Project FIO. AIDS and Behavior, 6, 1–13.CrossRef
Exner, T. M., Hoffman, S., Parikh, K., Leu, C., & Ehrhardt, A. (2002). HIV counseling and testing: Women’s experiences and the perceived role of testing as a prevention strategy. Perspectives on Sexual and Reproductive Health, 34, 76–83.CrossRefPubMed
Flaks, R. C., Burman, W. J., Gourley, P. J., Rietmeijer, C. A., & Cohn, D. L. (2003). HIV transmission risk behavior and its relation to antiretroviral treatment adherence. Sex Transmitted Diseases, 30, 399–404.CrossRef
Grant, R. M., Hecht, F. M., Warmerdam, M., Liu, L., Liegler, T., Petropoulos, C. J., Hellmann, N. S., Chesney, M., Busch, M. P., & Kahn, J. O. (2002). Time trends in primary HIV-1 drug resistance among recently infected persons. Journal of American Medical Association, 288, 181–188.CrossRef
Gribble, J. N., Miller, H. G., & Rogers, S. M. (1999). Interview mode and measurement of sexual behaviors: Methodological issues. Journal of Sex Research, 36, 16–24.CrossRef
Ingersoll, K. (2004). The impact of psychiatric symptoms, drug use, and medication regimen on non-adherence to HIV treatment. AIDS Care, 16, 199–211.CrossRefPubMed
Justice, A. C., Holmes, W., Gifford, A. L., Rabeneck, L., Zackin, R., Sinclair, G., Weissman, S., Neidig, J., Marcus, C., Chesney, M., Cohn, S. E., Wu, A. W., & Adult AIDS Clinical Trials Unit Outcomes Committee. (2001). Development and validation of a self-completed HIV symptom index. Journal of Clinical Epidemiology, 54, S77–S90.
Kalichman, S. C. (1999). Psychological and social correlates of high-risk sexual behaviour among men and women living with HIV/AIDS. AIDS Care, 11, 415–427.CrossRefPubMed
Kalichman, S. C., Cage, M., Barnett, T., Tharnish, P., Rompa, D., Austin, J., Luke, W., O’Mowrey, J., & Schinazi, R. F. (2001). Human immunodeficiency virus in semen and plasma: Investigation of sexual transmission risk behavioral correlates. AIDS Research and Human Retroviruses, 17, 1695–1703.CrossRefPubMed
Kalichman, S. C., & Rompa, D. (2003). HIV treatment adherence and unprotected sex practices in people receiving antiretroviral therapy. Sexually Transmitted Infections, 79, 59–61.CrossRefPubMed
Kalichman, S. C., Rompa, D., & Cage, M. (2000). Reliability and validity of self-reported CD4 lymphocyte count and viral load test results in people living with HIV/AIDS. International Journal of STD and AIDS, 11, 597–585.
Kalichman, S. C., Rompa, D., Cage, M., Austin, J., Luke, W., Barnett, T., Tharnish, P., Mowrey, J., & Schinazi, R. F. (2002). Sexual transmission risk perceptions and behavioural correlates of HIV concentrations in semen. AIDS Care, 14, 343–349.CrossRefPubMed
Kelly, J. A., Hoffman, R. G., Rompa, D., & Gray, M. (1998). Protease inhibitor combination therapies and perceptions of gay men regarding AIDS severity and the need to maintain safer sex. AIDS, 12, 91–95.CrossRef
Kelly, J. A., Murphy, D. A., Bahr, G. R., Koob, J. J., Morgan, M. G., Kalichman, S. C., Stevenson, L. Y., Brasfield, T. L., Bernstein, B. M., & St. Lawrence, J. S. (1993). Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection. Health Psychology, 12, 215–219.CrossRefPubMed
Kimberly, J. A., & Serovich, J. M. (1999). The role of family and friend social support in reducing risk behaviors among HIV-positive gay men. AIDS Education and Prevention, 11, 465–475.PubMed
Kozal, M. J., Amico, K. R., Chiarella, J., Schreibman, T., Cornman, D., Fisher, W., Fisher, J., & Friedland, G. (2004). Antiretroviral resistance and high-risk transmission behavior among HIV-positive patients in clinical care. AIDS, 18, 2185–2189.CrossRefPubMed
Latkin, C. A., Forman-Hoffman, V. L., D’Souza, G., & Knowlton, A. R. (2004). Associations between medical service use and HIV risk among HIV-positive drug users in Baltimore, MD. AIDS Care, 16, 901–908.CrossRefPubMed
Lee, S. J., Galanter, M., Dermatis, H., & McDowell, D. (2003). Circuit parties and patterns of drug use in a subset of gay men. Journal of Addictive Diseases, 22, 47–60.CrossRefPubMed
Lightfoot, M., Song, J., Rotheram-Borus, M. J., & Newman, P. (2005). The influence of partner type and risk status on the sexual behavior of young men who have sex with men living with HIV/AIDS. Journal of Acquired Immune Deficiency Syndromes, 38, 61–68.CrossRefPubMed
Little, S. J., Holte, S., Routy, J. P., Daar, E. S., Markowitz, M., Collier, A. C., Koup, R. A., Mellors, J. W., Connick, E., Conway, B., Kilby, M., Wang, L., Whitcomb, J. M., Hellmann, N. S., & Richman, D. D. (2002). Antiretroviral-drug resistance among patients recently infected with HIV. New England Journal of Medicine, 347, 385–394.CrossRefPubMed
Mellins, C. A., Kang, E., Leu, C. S., Havens, J. F., & Chesney, M. A. (2003). Longitudinal study of mental health psychosocial predictors of medical treatment adherence in mothers living with HIV disease. AIDS Patient Care and STDS, 17, 407–416.CrossRefPubMed
Meyer-Bahlburg, H., Ehrhardt, A., & Exner, T. M. (1991). Sexual risk behavior assessment ScheduleùAdultùArmory interview. New York: New York State Psychiatric Institute and Columbia University.
Meyers, H. F., Javanbakht, M., Martinez, M., & Obediah, S. (2003). Psychosocial predictors of risky sexual behaviors in African American men: Implications for prevention. AIDS Education and Prevention, 15(Suppl. 1), 66–79.CrossRef
Morin, S. F., Koester, K. A., Steward, W. T., Maiorana, A., McLaughlin, M., Myers, J. J., Vernon, K., & Chesney, M. A. (2004). Missed opportunities: prevention with HIV-infected patients in clinical care settings. Journal of Acquired Immune Deficiency Syndromes, 36, 960–966.CrossRefPubMed
Murphy, D. A., Wilson, C. M., Durako, S. J., Muenz, L. R., Belzer, M., & Adolescent HIV/AIDS Research Network. (2001). Antiretroviral adherence among the REACH HIV-infected adolescent cohort in the USA. AIDS Care, 13, 27–40.
Novotna, L., Wilson, T. E., Minkoff, H. L., McNutt, L. A., DeHovitz, J. A., Ehrlich, I., & Des Jarlais, D. C. (1999). Predictors and risk-taking consequences of drug use among HIV-infected women. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 20, 502–507.PubMed
Nwoye, A. (2004). Decision-making therapy in HIV/AIDS: The African Experience. Dialectical Anthropology, 28, 377–395.CrossRef
Ostrow, D. E., Fox, K. J., Chmiel, J. S., Silvestre, A., Visscher, B. R., Vanable, P. A., Jacobson, L. P., & Strathdee, S. A. (2002). Attitudes towards highly active antiretroviral therapy are associated with sexual risk taking among HIV-infected and uninfected homosexual men. AIDS, 16, 775–780.CrossRefPubMed
Parsons, J. T., Halkitis, P. N., Wolitski, R. J., Gomez, C. A., & Seropositive Urban Men’s Study Team (2003). Correlates of sexual risk behaviors among HIV-positive men who have sex with men. AIDS Education and Prevention, 15, 383–400.
Paterson, D. L., Swindells, S., Mohr, J., Brester, M., Vergis, E. N., Squier, C., Wagener, M. M., & Singh, N. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine, 133, 21–30.PubMed
Pbert, L., Doerfler, L. A., & DeCosimo, D. (1992). An evaluation of the perceived stress scale in two clinical populations. Journal of Psychopathology and Behavioral Assessment, 14, 363–375.CrossRef
Peretti-Watel, P., Spire, B., Schiltz, M. A., Bouhnik, A. D., Heard, I., Lert, F., Obadia, Y., & The VESPA Group. (2006). Vulnerability, unsafe sex and non-adherence to HARRT: Evidence from a large sample of French HIV/AIDS outpatients. Social Science & Medicine, 62, 2420–2433.
Perkins, D. O., Leserman, J., Murphy, C., & Evans, D. L. (1993). Psychosocial predictors of high-risk sexual behavior among HIV-negative homosexual men. AIDS Education and Prevention, 5, 141–152.PubMed
Power, R., Koopman, C., Volk, J., Osraelski, D. M., Stone, L., Chesney, M. A., & Spiegel, D. (2003). Social support, substance use, and denial in relationship to antiretroviral treatment adherence among HIV-infected persons. AIDS Patient Care and STDs, 17, 245–252.CrossRefPubMed
Reilly, T., & Woo, G. (2004). Social support and maintenance of safer sex practices among people living with HIV/AIDS. Health & Social Work, 29, 97–105.
Remien, R. H., Halkitis, P. N., O’leary, A., Wolitski, R. J., & Gomez, C. A. (2005). Risk perception and sexual risk behaviors among HIV-positive men on antiretroviral therapy. AIDS and Behavior, 9, 167–176.CrossRefPubMed
Richman, D. D., Morton, S. C., Wrin, T., Hellmann, N., Berry, S., Shapiro, M. F., & Bozzette, S. A. (2004). The prevalence of antiretroviral drug resistance in the United States. AIDS, 18, 1393–1401.CrossRefPubMed
Sethi, A. K., Celentano, D. D., Gange, S. J., Gallant, J. E., Vlahov, D., & Farzadegan, H. (2004). High-risk behavior and potential transmission of drug-resistant HIV among injection drug users. Journal of Acquired Immune Deficiency Syndromes, 35, 503–510.CrossRefPubMed
Sherman, D. W., & Kirton, C. A. (1999). The experience of relapse to unsafe sexual behavior among HIV-positive, heterosexual, minority men. Applied Nursing Research, 12, 91–100.CrossRefPubMed
Simoni, J. M., Kurth, A. E., Pearson, C. R., Pantalone, D. W., Merrill, J. O., & Frick, P. A. (2006). Self-report measures of antiretroviral therapy adherence: A review with recommendations for HIV research and clinical management. AIDS and Behavior, 10, 227–245.CrossRefPubMed
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1974). STAI manual for the state-trait anxiety inventory. Palo Alto: Consulting Psychologists Press.
Stirratt, M. J., Remien, R. H., Smith, A., Copeland, O. Q., Dolezal, C., & Krieger, D. (2006). The role of HIV serostatus disclosure in antiretroviral medication adherence. AIDS and Behavior, 10, 483–493.CrossRefPubMed
Tucker, J. S., Kanouse, D. E., Miu, A., Koegel, P., & Sullivan, G. (2003a). HIV risk behaviors and their correlates among HIV-positive adults with serious mental illness. AIDS and Behavior, 7, 29–40.CrossRef
Tucker, J. S., Burnam, M. A., Sherbourne, C. D., Kung, F. Y., & Gifford, A. L. (2003b). Substance use and mental health correlates of nonadherence to antiretroviral medications in a sample of patients with HIV. The American Journal of Medicine, 114, 573–580.CrossRef
Tun, W., Celentano, D., Vlahov, D. A., & Strathdee, S. A. (2003). Attitudes toward HIV treatments influence unsafe sexual and injection practices among injecting drug users. AIDS, 17, 1953–1962.CrossRefPubMed
Turner, C. F., Ku, L., Rogers, S. M., Lindberg, L. D., Pleck, J. H., & Sonenstein, F. L. (1998). Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science, 280, 867–873.CrossRefPubMed
Vanable, P. A., Ostrow, D. G., & McKirnan, D. J. (2003). Viral load and HIV treatment attitudes as correlates of sexual risk behavior among HIV-positive gay men. Journal of Psychosomatic Research, 54, 263–269.CrossRefPubMed
Wahl, L. M., & Nowak, M. A. (2000). Adherence and drug resistance: Predictions for therapy outcome. Proceedings. Biological Sciences/The Royal Society, 267, 835–843.
Weiser, S. D., Riley, E. D., Ragland, K., Hammer, G., Clark, R., & Bangsberg, D. R. (2006). Brief report: Factors associated with depression among homeless and marginally housed HIV-infected men in San Francisco. Journal of General Internal Medicine, 21, 61–64.CrossRefPubMed
Wilson, T. E., Barron, Y., Cohen, M., Richardson, J., Greenblatt, R., Sacks, H. S., Young, M., & Women’s Interagency HIV Study (2002). Adherence to antiretroviral therapy and its association with sexual behavior in a national sample of women with human immunodeficiency virus. Clinical Infectious Diseases, 34, 529–534.
Wyatt, G. E., Myers, H. F., Williams, J. K., Kitchen, C. R., Loeb, T., Carmona, J. V., Wyatt, L. E., Chin, D., & Presley, N. (2002). Does a history of trauma contribute to HIV risk for women of color? Implications for prevention and policy. American Journal of Public Health, 92, 660–665.PubMedCrossRef
Metadata
Title
Medication Adherence and Sexual Risk Behavior among HIV-Infected Adults: Implications for Transmission of Resistant Virus
Authors
Robert H. Remien
Theresa M. Exner
Stephen F. Morin
Anke A. Ehrhardt
Mallory O. Johnson
Jackie Correale
Stephanie Marhefka
Sheri B. Kirshenbaum
Lance S. Weinhardt
Mary Jane Rotheram-Borus
Sheryl L. Catz
Cheryl Gore-Felton
Margaret A. Chesney
Jeffrey Kelly
The NIMH Healthy Living Project Team
Publication date
01-09-2007
Publisher
Springer US
Published in
AIDS and Behavior / Issue 5/2007
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-006-9201-8

Other articles of this Issue 5/2007

AIDS and Behavior 5/2007 Go to the issue

Original Paper

Ongoing Risk Behavior Among Persons With HIV in Medical Care

Original Paper

Motivations and Methods for Self-disclosure of HIV Seropositivity in Nairobi, Kenya

Original Paper

Correlates of Risk Patterns and Race/Ethnicity among HIV-Positive Men who have Sex with Men

Original Paper

HIV Voluntary Counseling and Testing among Injection Drug Users in South China: A Study of a Non-Government Organization Based Program

Original Paper

Some Data-Driven Reflections on Priorities in AIDS Network Research

Original Paper

Community-based Voluntary Counseling and Testing Services in Rural Communities of Chiang Mai Province, Northern Thailand
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

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

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

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

Watch now

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