Jane M. Simoni|David Huh|Ira B. Wilson|Jie Shen|Kathy Goggin|Nancy Reynolds|Robert H. Remien|Marc I. Rosen|David R. Bangsberg|Honghu Liu
Racial/Ethnic Disparities in ART Adherence in the United States
University of Washington|University of Washington|Brown University|Providence College|University of California, Los Angeles|University of Missouri–Kansas City|Yale University|Columbia College|Royal College of Physicians|Columbia University|Yale University|Massachusetts General Hospital|Harvard University|University of California, Los Angeles
minority raceethnicity generally associated antiretroviral therapy nonadherence usbased studies limitations existing literature include small samples subjective adherence measures inadequate control potential confounders mental health substance use consistently associated poorer adherenceindividuallevel data pooled 13 usbased studies employing electronic drug monitoring assess adherence adherence operationalized percent prescribed doses taken first 12 monthly waves data study depression symptoms aggregated several widely used assessments substance use operationalized use cocainestimulants heroinopiates ecstasy hallucinogens sedatives 30365 days preceding baselinethe final analytic sample 1809 participants ranged age 18 72 years 67 male participants 53 african american 14 latino 34 white logistic regression adjusting age gender income education site raceethnicity significantly associated adherence p 0001 persisted model also controlled depression substance use p 0001 african americans significantly lower adherence latinos odds ratio 072 p 004 whites 060 p 0001 adherence differ whites latinos 084 p 027racialethnic differences demographics depression substance abuse explain lower level antiretroviral therapy adherence african americans observed sample research needed explain persistent disparity might examine factors mistrust providers health literacy inequities health care system