Department of Psychology, Fordham University, Bronx, New York, USA.
Department of Neurology and Icahn School of Medicine at Mount Sinai, New York, New York, USA.
AIDS Patient Care STDS. 2020 Aug;34(8):344-355. doi: 10.1089/apc.2019.0256.
Antiretroviral therapy (ART) adherence is vital for optimal HIV treatment. However, there is limited ART adherence research on the US Latinx population, who are at increased risk for HIV infection and worse HIV health outcomes. This study examined electronically measured ART adherence (Medication Event Monitoring System) and its association with demographic, clinical, neurocognitive, and sociocultural variables in Latinx and non-Latinx white (NLW) persons living with HIV [PLWH ( = 128)]. Latinx participants demonstrated worse adherence than NLW participants ( = 0.04). Linear regressions revealed different predictors of adherence. Among Latinx participants, recent cocaine use, stress, and, unexpectedly, higher US acculturation predicted worse adherence (s < 0.05). Among NLW participants, recent cocaine use predicted worse adherence ( < 0.05). Intergroup comparisons within the Latinx group were not conducted due to subsample size. Thus, ethnicity, sociocultural variables, and cocaine use are important considerations for ART adherence, and poor ART adherence may be one pathway explaining worse outcomes in Latinx PLWH. Culturally tailored adherence interventions incorporating substance use treatment, acculturation, and stress management are warranted to improve health outcomes.
抗逆转录病毒疗法（ART）的依从性对于最佳的 HIV 治疗至关重要。然而，针对美国拉丁裔人群的 ART 依从性研究有限，而拉丁裔人群感染 HIV 的风险增加，HIV 健康结局也更差。本研究通过电子方式（药物事件监测系统）测量了 HIV 感染者中拉丁裔和非拉丁裔白人（NLW）人群的 ART 依从性，并分析了其与人口统计学、临床、神经认知和社会文化变量之间的关联（ = 128）。拉丁裔参与者的依从性比 NLW 参与者差（ = 0.04）。线性回归显示，不同的变量可以预测依从性。在拉丁裔参与者中，最近使用可卡因、压力，以及出人意料的是，较高的美国文化融入度预测了较差的依从性（s < 0.05）。在 NLW 参与者中，最近使用可卡因预测了较差的依从性（ < 0.05）。由于亚组样本量较小，因此未在拉丁裔组内进行组间比较。因此，族裔、社会文化变量和可卡因使用是影响 ART 依从性的重要因素，而较差的 ART 依从性可能是导致拉丁裔 HIV 感染者结局较差的一个途径。需要制定针对文化的依从性干预措施，包括药物使用治疗、文化融入和压力管理，以改善健康结局。
