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AIDS Care
Psychological and Socio-medical Aspects of AIDS/HIV
Volume 33, 2021 - Issue 11
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Articles

Sociodemographic and psychosocial predictors of longitudinal antiretroviral therapy (ART) adherence among first-time ART initiators in Cape Town, South Africa

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Pages 1394-1403 | Received 21 Jan 2020, Accepted 09 Jul 2020, Published online: 23 Jul 2020
 

ABSTRACT

First-time antiretroviral therapy (ART) initiators may be more vulnerable to poor ART adherence because they may be coping with a new HIV diagnosis, facing logistical challenges to accessing and adhering to ART for the first time, and have not yet developed support networks or the skills to support long-term adherence. We recruited 324 participants in two HIV clinics near Cape Town, South Africa. Sociodemographic/psychosocial factors were measured at baseline and self-reported adherence at the 6 month follow-up. We conducted multivariable regression to determine which baseline factors were associated with 6-month adherence. A better patient-clinic relationship score (OR: 1.08 [95% CI: 1.05–1.11]) was associated with higher adherence. A drug use problem (0.51 [0.29–0.87]), higher social isolation (0.93 [0.87–0.99]), and greater number of years living with HIV before initiating ART (0.92 [0.86–1.00]) were associated with adherence levels below 90%. Patient-clinic relationships and social support are key psycho-social factors in early adherence behavior. Reducing drug use problems through targeted screening and early intervention may improve ART adherence.

Disclosure statement

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

Additional information

Funding

This work was supported by National Institute of Mental Health [grant number P30MH043520, R01MH095576, T32MH019139]; National Institute on Drug Abuse [grant number K01DA044853].

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