Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, Ontario
Background We aimed to identify the association between stress and antiretroviral therapy (ART) adherence among women in HIV care in Toronto, Ontario participating in the Ontario HIV Treatment Network Cohort Study (OCS) between 2007 and 2012. Materials and methods We conducted cross-sectional analys...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-05-01
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| Series: | HIV Research & Clinical Practice |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/25787489.2020.1763711 |
| _version_ | 1827794887089586176 |
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| author | Anita C. Benoit Ann N. Burchell Kelly K. O’Brien Janet Raboud Sandra Gardner Lucia Light Kerrigan Beaver Jasmine Cotnam Tracey Conway Colleen Price Sean B. Rourke Sergio Rueda Trevor A. Hart Mona Loutfy on behalf of the OHTN Cohort Study Team |
| author_facet | Anita C. Benoit Ann N. Burchell Kelly K. O’Brien Janet Raboud Sandra Gardner Lucia Light Kerrigan Beaver Jasmine Cotnam Tracey Conway Colleen Price Sean B. Rourke Sergio Rueda Trevor A. Hart Mona Loutfy on behalf of the OHTN Cohort Study Team |
| author_sort | Anita C. Benoit |
| collection | DOAJ |
| description | Background We aimed to identify the association between stress and antiretroviral therapy (ART) adherence among women in HIV care in Toronto, Ontario participating in the Ontario HIV Treatment Network Cohort Study (OCS) between 2007 and 2012. Materials and methods We conducted cross-sectional analyses with women on ART completing the AIDS Clinical Trial Group (ACTG) Adherence Questionnaire. Data closest to, or at the last completed interview, were collected from medical charts, through record linkage with Public Health Ontario Laboratories, and from a standardized self-reported questionnaire comprised of socio-demographic and psycho-socio-behavioral measures (Center for Epidemiologic Studies Depression Scale (CES-D), Alcohol Use Disorders Identification Test (AUDIT)), and stress measures (National Population Health Survey). Logistic regression was used to quantify associations with optimal adherence (≥95% adherence defined as missing ≤ one dose of ART in the past 4 weeks). Results Among 307 women, 65.5% had optimal adherence. Women with suboptimal compared to optimal adherence had higher median total stress scores (6.0 [interquartile range (IQR): 3.0–8.1] vs. 4.1 [IQR: 2.0–7.1], p = 0.001), CES-D scores (16 [IQR: 6–28] vs. 12 [IQR: 3–22], p = 0.008) and reports of hazardous and harmful alcohol use (31.1% vs. 17.9%, p = 0.008). In our multivariable model, we found an increased likelihood of optimal adherence with the absence of hazardous and harmful alcohol use (Adjusted Odds Ratio (AOR)=2.20, 95% confidence interval (CI): 1.12–4.32) and a decreased likelihood of optimal adherence with more self-reported stress (AOR = 0.56, 95% CI: 0.33–0.94). Conclusions Interventions supporting optimal ART adherence should address stress and include strategies to reduce or eliminate hazardous and harmful alcohol use for women living with HIV. |
| first_indexed | 2024-03-11T18:40:15Z |
| format | Article |
| id | doaj.art-e2aee598786a4966b9006f6942a284a2 |
| institution | Directory Open Access Journal |
| issn | 2578-7470 |
| language | English |
| last_indexed | 2024-03-11T18:40:15Z |
| publishDate | 2020-05-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | HIV Research & Clinical Practice |
| spelling | doaj.art-e2aee598786a4966b9006f6942a284a22023-10-12T13:43:52ZengTaylor & Francis GroupHIV Research & Clinical Practice2578-74702020-05-01212-3455510.1080/25787489.2020.17637111763711Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, OntarioAnita C. Benoit0Ann N. Burchell1Kelly K. O’Brien2Janet Raboud3Sandra Gardner4Lucia Light5Kerrigan Beaver6Jasmine Cotnam7Tracey Conway8Colleen Price9Sean B. Rourke10Sergio Rueda11Trevor A. Hart12Mona Loutfy13on behalf of the OHTN Cohort Study TeamWomen’s College Research Institute, Women’s College Hospital, University of TorontoDalla Lana School of Public Health, University of TorontoDepartment of Physical Therapy, University of TorontoDalla Lana School of Public Health, University of TorontoDalla Lana School of Public Health, University of TorontoOntario HIV Treatment NetworkWomen’s College Research Institute, Women’s College Hospital, University of TorontoWomen’s College Research Institute, Women’s College Hospital, University of TorontoProject Community Advisory Committee, Ontario HIV Treatment Network Cohort StudyProject Community Advisory Committee, Ontario HIV Treatment Network Cohort StudyCentre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s HospitalDepartment of Psychiatry, University of TorontoDalla Lana School of Public Health, University of TorontoWomen’s College Research Institute, Women’s College Hospital, University of TorontoBackground We aimed to identify the association between stress and antiretroviral therapy (ART) adherence among women in HIV care in Toronto, Ontario participating in the Ontario HIV Treatment Network Cohort Study (OCS) between 2007 and 2012. Materials and methods We conducted cross-sectional analyses with women on ART completing the AIDS Clinical Trial Group (ACTG) Adherence Questionnaire. Data closest to, or at the last completed interview, were collected from medical charts, through record linkage with Public Health Ontario Laboratories, and from a standardized self-reported questionnaire comprised of socio-demographic and psycho-socio-behavioral measures (Center for Epidemiologic Studies Depression Scale (CES-D), Alcohol Use Disorders Identification Test (AUDIT)), and stress measures (National Population Health Survey). Logistic regression was used to quantify associations with optimal adherence (≥95% adherence defined as missing ≤ one dose of ART in the past 4 weeks). Results Among 307 women, 65.5% had optimal adherence. Women with suboptimal compared to optimal adherence had higher median total stress scores (6.0 [interquartile range (IQR): 3.0–8.1] vs. 4.1 [IQR: 2.0–7.1], p = 0.001), CES-D scores (16 [IQR: 6–28] vs. 12 [IQR: 3–22], p = 0.008) and reports of hazardous and harmful alcohol use (31.1% vs. 17.9%, p = 0.008). In our multivariable model, we found an increased likelihood of optimal adherence with the absence of hazardous and harmful alcohol use (Adjusted Odds Ratio (AOR)=2.20, 95% confidence interval (CI): 1.12–4.32) and a decreased likelihood of optimal adherence with more self-reported stress (AOR = 0.56, 95% CI: 0.33–0.94). Conclusions Interventions supporting optimal ART adherence should address stress and include strategies to reduce or eliminate hazardous and harmful alcohol use for women living with HIV.http://dx.doi.org/10.1080/25787489.2020.1763711stressdepressionantiretroviral therapywomenhiv |
| spellingShingle | Anita C. Benoit Ann N. Burchell Kelly K. O’Brien Janet Raboud Sandra Gardner Lucia Light Kerrigan Beaver Jasmine Cotnam Tracey Conway Colleen Price Sean B. Rourke Sergio Rueda Trevor A. Hart Mona Loutfy on behalf of the OHTN Cohort Study Team Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, Ontario HIV Research & Clinical Practice stress depression antiretroviral therapy women hiv |
| title | Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, Ontario |
| title_full | Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, Ontario |
| title_fullStr | Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, Ontario |
| title_full_unstemmed | Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, Ontario |
| title_short | Examining the association between stress and antiretroviral therapy adherence among women living with HIV in Toronto, Ontario |
| title_sort | examining the association between stress and antiretroviral therapy adherence among women living with hiv in toronto ontario |
| topic | stress depression antiretroviral therapy women hiv |
| url | http://dx.doi.org/10.1080/25787489.2020.1763711 |
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