Aurélie Rotzinger1, Isabella Locatelli2, Matthias Reymermier3, Sebastian Amico3, Olivier Bugnon1, Matthias Cavassini4, Marie Paule Schneider5. 1. Community pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland; Community pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne, Lausanne, Switzerland. 2. Department of Ambulatory care & Community Medicine, University of Lausanne, Lausanne, Switzerland. 3. Community pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne, Lausanne, Switzerland. 4. Infectious Disease Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. 5. Community pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland; Community pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne, Lausanne, Switzerland. Electronic address: marie-paule.schneider@hospvd.ch.
Abstract
OBJECTIVE: Disclosure may affect adherence to antiretroviral treatment. In a medication adherence program, this cross-sectional study describes disclosure, perceived reaction after disclosure, living situations, and the relationship of disclosure with antiretroviral adherence. METHODS: A combination of a questionnaire to measure disclosure and longitudinal electronic monitoring of medication adherence was used. RESULTS: A total of 103 out of 159 eligible patients gave informed consent. The characteristics differed between participants and nonparticipants (race, education, sexual orientation, medication adherence). Thirteen participants did not disclose their HIV status. Seventy-three (81%) participants judged the reaction after disclosure positive. Among the 62 participants cohabiting, 52% disclosed to all co-residents. Adherence was high (median 100%). HIV disclosure was negatively associated with adherence, when disclosing to the mother (OR=2.46, p-value=0.086) and to siblings (OR=2.89, p-value=0.029). Living alone was associated to a lower adherence than cohabitation (Rate Ratio=1.42, p-value=0.007). CONCLUSION: HIV disclosure and adherence are sensitive issues, which may explain the reason for refusal. Nonparticipants may be those with the most difficulties disclosing. PRACTICE IMPLICATIONS: An unbiased collection of sensitive information, as HIV disclosure, is a difficult task. A cohort design, with research data collected systematically by a trusted healthcare provider, may better describe the association between adherence and disclosure.
OBJECTIVE: Disclosure may affect adherence to antiretroviral treatment. In a medication adherence program, this cross-sectional study describes disclosure, perceived reaction after disclosure, living situations, and the relationship of disclosure with antiretroviral adherence. METHODS: A combination of a questionnaire to measure disclosure and longitudinal electronic monitoring of medication adherence was used. RESULTS: A total of 103 out of 159 eligible patients gave informed consent. The characteristics differed between participants and nonparticipants (race, education, sexual orientation, medication adherence). Thirteen participants did not disclose their HIV status. Seventy-three (81%) participants judged the reaction after disclosure positive. Among the 62 participants cohabiting, 52% disclosed to all co-residents. Adherence was high (median 100%). HIV disclosure was negatively associated with adherence, when disclosing to the mother (OR=2.46, p-value=0.086) and to siblings (OR=2.89, p-value=0.029). Living alone was associated to a lower adherence than cohabitation (Rate Ratio=1.42, p-value=0.007). CONCLUSION:HIV disclosure and adherence are sensitive issues, which may explain the reason for refusal. Nonparticipants may be those with the most difficulties disclosing. PRACTICE IMPLICATIONS: An unbiased collection of sensitive information, as HIV disclosure, is a difficult task. A cohort design, with research data collected systematically by a trusted healthcare provider, may better describe the association between adherence and disclosure.
Authors: Crystal Chapman Lambert; Will L Tarver; Pamela L Musoke; Kristi L Stringer; Samantha Whitfield; Bulent Turan; Riddhi Modi; Michael J Mugavero; Rob J Fredericksen; Sheri Weiser; Mallory O Johnson; Janet M Turan Journal: J Assoc Nurses AIDS Care Date: 2020 Mar-Apr Impact factor: 1.354
Authors: Lei He; Bin Yu; Jun Yu; Jun Xiong; Yuling Huang; Tian Xie; Qi Chai; Bo Gao; Shujuan Yang Journal: BMC Public Health Date: 2021-12-11 Impact factor: 3.295