Depression, Substance Abuse and Other Contextual Predictors of Adherence to Antiretroviral Therapy (ART) Among Haitians

被引:0
作者
Robert Malow
Jessy G. Dévieux
Judith A. Stein
Rhonda Rosenberg
Michele Jean-Gilles
Jennifer Attonito
Serena P. Koenig
Giuseppe Raviola
Patrice Sévère
Jean W. Pape
机构
[1] Robert Stempel College of Public Health & Social Work,Department of Health Promotion & Disease Prevention
[2] Florida International University,Department of Psychology
[3] UCLA,Division of Global Health Equity
[4] Brigham and Women’s Hospital,Department of Global Health and Social Medicine
[5] Harvard Medical School,Division of Infectious Diseases, Department of Medicine
[6] Harvard Medical School,undefined
[7] Les Centres GHESKIO,undefined
[8] Weill Cornell Medical College,undefined
来源
AIDS and Behavior | 2013年 / 17卷
关键词
Antiretroviral therapy; Haitians; Adherence; Depression;
D O I
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中图分类号
学科分类号
摘要
Haiti has the highest number of individuals living with HIV in the Caribbean. Due to Haiti’s resource-poor environment and inadequate mental health and substance abuse services, adherence to antiretroviral therapy (ART) may be especially difficult. This study examined associations among demographics, maladaptive coping, partner conflict, alcohol problems, depression, and negative attitudes about medications and their impact on adherence among 194 HIV-positive Haitians. In a mediated directional structural equation model, depression and negative attitudes about ART directly predicted poorer adherence. Greater partner conflict, maladaptive coping and alcohol problems predicted more depression. Maladaptive coping predicted a negative attitude about ART. Alcohol problems predicted partner conflict and maladaptive coping. Significant indirect effects on adherence mediated through both depression and negative attitudes about ART include negative effects of female gender, alcohol problems and maladaptive coping. Results highlight the importance of integrated care for depression, alcohol use and other psychosocial problems to increase ART adherence.
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页码:1221 / 1230
页数:9
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