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Trauma exposure, PTSD, and suboptimal HIV medication adherence among marginalized individuals connected to public HIV care in Miami.

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Title: Trauma exposure, PTSD, and suboptimal HIV medication adherence among marginalized individuals connected to public HIV care in Miami.
Authors: Glynn, Tiffany R., Mendez, Noelle A., Jones, Deborah L., Dale, Sannisha K., Carrico, Adam W., Feaster, Daniel J., Rodriguez, Allan E., Safren, Steven A.
Source: Journal of Behavioral Medicine. Apr2021, Vol. 44 Issue 2, p147-158. 12p. 4 Charts.
Subjects: Wounds & injuries, Post-traumatic stress disorder, Patient compliance, Cross-sectional method, Statistical correlation, African Americans, Hispanic Americans, Socioeconomic factors, HIV-positive persons, HIV infections, Patient care, Communities, Research, Anti-HIV agents, Drugs, Public health, Discrimination (Sociology), Health equity, Regression analysis
Geographic Terms: Florida
Abstract: Individuals living with HIV report disproportionately high levels of trauma exposure and PTSD symptoms, both which have been associated with suboptimal ART adherence. Often conflated, the question arises as to which construct is driving subsequent HIV self-care behavior. Given the HIV disparities among Black and Hispanic/Latinx individuals, and that Miami is a geographic region with a high racial/ethnic minority make up and a unique socioeconomic environment, it is important to explore factors related to HIV outcomes in Miami to mitigate its uncontrolled epidemic. This study aimed to examine the association of trauma exposure, PTSD symptoms, and relevant additional key factors with adherence to ART among a sample of majority Black and Hispanic/Latinx individuals who are economically marginalized receiving public HIV care in Miami, FL (N = 1237) via a cross-sectional survey. Sequential linear regression was used to examine the study aim in four blocks: (1) trauma, (2) PTSD symptoms, and key covariates of ART adherence including (3) depression and substance use (potential psychological covariates), and (4) indicators of socioeconomic status (potential structural covariates). In the first block, trauma exposure was associated with worse adherence. However, in the second block, the association with trauma dropped and PTSD was significantly associated with worse adherence. Of note, for those experiencing high levels of trauma exposure, adherence was negatively impacted regardless of PTSD. When other key factors associated with adherence were entered in the third and fourth blocks, neither trauma exposure nor PTSD were uniquely significant. In this final model, depression, substance use, and unstable housing were uniquely associated with worse adherence. Trauma-informed models of HIV care that holistically address co-occurring factors are warranted to cater to communities with HIV health disparities and keep them from falling off the HIV care continuum. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Behavioral Medicine is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Trauma exposure, PTSD, and suboptimal HIV medication adherence among marginalized individuals connected to public HIV care in Miami.
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Behavioral+Medicine%22">Journal of Behavioral Medicine</searchLink>. Apr2021, Vol. 44 Issue 2, p147-158. 12p. 4 Charts.
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  Data: Individuals living with HIV report disproportionately high levels of trauma exposure and PTSD symptoms, both which have been associated with suboptimal ART adherence. Often conflated, the question arises as to which construct is driving subsequent HIV self-care behavior. Given the HIV disparities among Black and Hispanic/Latinx individuals, and that Miami is a geographic region with a high racial/ethnic minority make up and a unique socioeconomic environment, it is important to explore factors related to HIV outcomes in Miami to mitigate its uncontrolled epidemic. This study aimed to examine the association of trauma exposure, PTSD symptoms, and relevant additional key factors with adherence to ART among a sample of majority Black and Hispanic/Latinx individuals who are economically marginalized receiving public HIV care in Miami, FL (N = 1237) via a cross-sectional survey. Sequential linear regression was used to examine the study aim in four blocks: (1) trauma, (2) PTSD symptoms, and key covariates of ART adherence including (3) depression and substance use (potential psychological covariates), and (4) indicators of socioeconomic status (potential structural covariates). In the first block, trauma exposure was associated with worse adherence. However, in the second block, the association with trauma dropped and PTSD was significantly associated with worse adherence. Of note, for those experiencing high levels of trauma exposure, adherence was negatively impacted regardless of PTSD. When other key factors associated with adherence were entered in the third and fourth blocks, neither trauma exposure nor PTSD were uniquely significant. In this final model, depression, substance use, and unstable housing were uniquely associated with worse adherence. Trauma-informed models of HIV care that holistically address co-occurring factors are warranted to cater to communities with HIV health disparities and keep them from falling off the HIV care continuum. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Behavioral Medicine is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1007/s10865-020-00191-w
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 147
    Subjects:
      – SubjectFull: Wounds & injuries
        Type: general
      – SubjectFull: Post-traumatic stress disorder
        Type: general
      – SubjectFull: Patient compliance
        Type: general
      – SubjectFull: Cross-sectional method
        Type: general
      – SubjectFull: Statistical correlation
        Type: general
      – SubjectFull: African Americans
        Type: general
      – SubjectFull: Hispanic Americans
        Type: general
      – SubjectFull: Socioeconomic factors
        Type: general
      – SubjectFull: HIV-positive persons
        Type: general
      – SubjectFull: HIV infections
        Type: general
      – SubjectFull: Patient care
        Type: general
      – SubjectFull: Communities
        Type: general
      – SubjectFull: Research
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      – SubjectFull: Anti-HIV agents
        Type: general
      – SubjectFull: Drugs
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      – SubjectFull: Public health
        Type: general
      – SubjectFull: Discrimination (Sociology)
        Type: general
      – SubjectFull: Health equity
        Type: general
      – SubjectFull: Regression analysis
        Type: general
      – SubjectFull: Florida
        Type: general
    Titles:
      – TitleFull: Trauma exposure, PTSD, and suboptimal HIV medication adherence among marginalized individuals connected to public HIV care in Miami.
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              Text: Apr2021
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