TY - JOUR
T1 - Psychosocial impact of poverty on antiretroviral nonadherence among HIV-TB coinfected patients in Lima, Peru
AU - Shin, Sonya
AU - Muñoz, Maribel
AU - Espiritu, Betty
AU - Zeladita, Jhon
AU - Sanchez, Eduardo
AU - Callacna, Miriam
AU - Rojas, Christian
AU - Arevalo, Jorge
AU - Ying Wu, Wu
AU - Caldas, Adolfo
AU - Sebastian, Jose Luis
PY - 2008/3
Y1 - 2008/3
N2 - Objective. Tuberculosis and HIV coinfection poses unique clinical and psychosocial complexities that can impact nonadherence to highly active antiretroviral treatment (HAART). Methods. This was a prospective case series to identify risk factors for HAART nonadherence among 43 patients with HIV and tuberculosis (TB) in Lima, Peru. Nonadherence was defined by patient self-report. Results. The median initial CD4 and HIV viral load were 63 and 159,000, respectively. Patients had received a median of 6.1 months of ART. Univariable analysis found low social support, substance use, and depression to be associated with nonadherence. In multivariable analysis, low social support was associated with nonadherence. Conclusions. In the authors' urban cohort of HIV-TB coinfected individuals in Lima, Peru, substance use, depression, and lack of social support were key barriers to adherence. These findings suggest that adherence interventions may be unsuccessful unless they target the underlying psychosocial challenges faced by patients living with TB and AIDS.
AB - Objective. Tuberculosis and HIV coinfection poses unique clinical and psychosocial complexities that can impact nonadherence to highly active antiretroviral treatment (HAART). Methods. This was a prospective case series to identify risk factors for HAART nonadherence among 43 patients with HIV and tuberculosis (TB) in Lima, Peru. Nonadherence was defined by patient self-report. Results. The median initial CD4 and HIV viral load were 63 and 159,000, respectively. Patients had received a median of 6.1 months of ART. Univariable analysis found low social support, substance use, and depression to be associated with nonadherence. In multivariable analysis, low social support was associated with nonadherence. Conclusions. In the authors' urban cohort of HIV-TB coinfected individuals in Lima, Peru, substance use, depression, and lack of social support were key barriers to adherence. These findings suggest that adherence interventions may be unsuccessful unless they target the underlying psychosocial challenges faced by patients living with TB and AIDS.
KW - HIV
KW - adherence
KW - poverty
KW - social support
KW - tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=59049091184&partnerID=8YFLogxK
U2 - 10.1177/1545109708315326
DO - 10.1177/1545109708315326
M3 - Artículo
C2 - 18319510
AN - SCOPUS:59049091184
SN - 1545-1097
VL - 7
SP - 74
EP - 81
JO - Journal of the International Association of Physicians in AIDS Care
JF - Journal of the International Association of Physicians in AIDS Care
IS - 2
ER -