Exploring individual-level barriers to HIV medication adherence among men who have sex with men in the HIV Prevention Trials Network (HPTN 065) study

ABSTRACT

African-American men who have sex with men (MSM) with HIV are more likely to have unsuppressed viral load than other racial/ethnic groups. HPTN 065 Study, completed in 2015, consisted of five interconnected study components conducted at clinics in Bronx, New York and Washington, D.C. Participants completed surveys with questions related to socio-demographic factors and individual-level HIV medication adherence barriers, such as forgetting doses or fear of taking medications in front of others. Descriptive analyses and ordinal logistic regression with robust standard errors were conducted. Fifty-seven per cent of participants (N = 359) were African-American (57.1%) and roughly 40% had no more than a high school education. Mean age was 48 years. Overall, MSM with viral load suppression identified fewer individual-level barriers to adherence (p < .01) and individuals with depressive symptoms identified a greater number of barriers to adherence (p < .01). Compared to African-Americans, white MSM had a lower likelihood of identifying barriers to adherence (p < .05). Findings suggest that individual-level barriers to HIV medication adherence are common among MSM, irrespective of time since diagnosis and viral suppression. Race-specific interventions which address intersectional stigma are needed to improve health outcomes among African-American MSM, who bear much of the burden of poor HIV outcomes in the United States.

KEYWORDS:

• HIV/AIDS
• African Americans
• Health disparities
• HIV medication adherence
• stigma
• social

Acknowledgments

The HIV Prevention Trials Network (HPTN) is funded by the National Institute of Allergy and Infectious Diseases (UM1AI068619, UM1AI068613, UM1AI1068617), with co-funding from the National Institute of Mental Health, and the National Institute on Drug Abuse, all components of the U.S. National Institutes of Health. The authors thank the participants and study staff at the HPTN 065 clinic sites located in the Bronx, NY and Washington, DC. Participating sites were Jacobi Medical Center; Lincoln Medical and Mental Health Center; Montefiore Adolescent AIDS Program; Montefiore Comprehensive Family Care Center/Montefiore CFCC/Montefiore CHCC/Montefiore Williamsbridge Family Practice; Montefiore AIDS Center; Capital Medical Associates; Family and Medical Counseling Services, Inc; Georgetown University; George Washington University Medical Faculty Associates; Veterans Affairs Medical Center, Washington, DC; Whitman Walker Clinic. Finally, the authors would like to thank the HTPN Scholars Program: Sten Vermund, Darrell Wheeler, Quarraisha Abdool-Karim, David Serwadda, Erica Hamilton, Sherri Johnson, Tanette Headen, and Gabriela Salinas-Jimenez.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by HIV Prevention Trials Network Domestic Scholars Program [grant number UM1AI068613], [grant number UM1AI068619], [grant number UM1AI1068617].