Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA.
Unconditional Love Incorporated, Melbourne, FL, USA.
AIDS Behav. 2024 Mar;28(3):1047-1057. doi: 10.1007/s10461-023-04214-w. Epub 2023 Oct 20.
Little is known about HIV medication concealment behaviors and the effect of medication concealment on antiretroviral therapy (ART) adherence among people with HIV (PWH). This study aims to (1) to describe medication concealment behaviors and factors associated with these behaviors, and (2) assess the association between medication concealment and suboptimal ART adherence. The Florida Cohort Study enrolled adult PWH from community-based clinics around the state from October 2020 to September 2022 (n = 416, 62% aged 50+, 56% male, 44% non-Hispanic Black, 18% Hispanic). Participants responded to questions about sociodemographics, stigma, ART adherence (≥ 85%), symptoms of depression, social networks and disclosure to their networks, and actions to conceal ART to avoid inadvertent disclosure of their HIV status. Analyses were conducted using multivariable logistic regressions models. The most common concealment behavior was hiding ART while having guests over (32%), followed by removing ART labels (26%), and putting ART into a different bottle (16%). Overall, 43% reported ≥ 1 behavior. In multivariable models, depressive symptoms, incomplete disclosure of HIV to close social networks, and not having a close social network were associated with ART concealment. After adjusting for risk factors for suboptimal ART adherence, endorsing hiding medication while having guests was associated with suboptimal ART adherence (aOR 2.87, 95% CI 1.15-7.55). Taking any action and other individual behaviors were not associated. ART concealment behaviors were common but did not consistently negatively influence adherence when accounting for other factors. PWH may want to receive ART medications in ways that ensure privacy and reduce the risk of inadvertent disclosure.
人们对 HIV 药物隐瞒行为以及药物隐瞒对 HIV 感染者（PWH）抗逆转录病毒治疗（ART）依从性的影响知之甚少。本研究旨在：（1）描述药物隐瞒行为及其相关因素，（2）评估药物隐瞒与 ART 依从性不足的关联。佛罗里达队列研究于 2020 年 10 月至 2022 年 9 月从全州的社区诊所招募成年 PWH（n=416，62%年龄在 50 岁以上，56%为男性，44%为非西班牙裔黑人，18%为西班牙裔）。参与者回答了有关社会人口统计学、耻辱感、ART 依从性（≥85%）、抑郁症状、社交网络和向网络披露情况，以及隐瞒 ART 以避免无意中透露 HIV 状态的行为等问题。分析采用多变量逻辑回归模型。最常见的隐瞒行为是在有客人时隐藏 ART（32%），其次是去除 ART 标签（26%）和将 ART 放入不同的瓶子（16%）。总体而言，43%的人报告了≥1 种行为。在多变量模型中，抑郁症状、对亲密社交网络不完全披露 HIV 信息以及没有亲密社交网络与 ART 隐瞒有关。在调整了 ART 依从性不足的风险因素后，承认在有客人时隐藏药物与 ART 依从性不足有关（优势比 2.87，95%置信区间 1.15-7.55）。采取任何行动和其他个人行为与结果无关。ART 隐瞒行为很常见，但在考虑其他因素时，并不总是对依从性产生负面影响。PWH 可能希望以确保隐私和降低无意披露风险的方式接受 ART 药物治疗。
