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Background <p>Although Argentina provides access to no cost HIV care, treatment adherence and retention in care remain suboptimal. This study aimed to explore factors associated with self-reported adherence and appointment attendance over time.</p> Method <p>Participants (<i>N</i> = 360) were people living with HIV (PLWH) that were lost to care (i.e., three missed pharmacy pickups in the last 6&#xa0;months, or had not attended a physician visit in the last 12&#xa0;months). Participants were recruited from seven HIV clinics in four urban centers in Argentina and re-engaged in care. Demographic variables, predictors, i.e., alcohol use, self-efficacy, motivation, patient-provider communication, insurance type (private/public), and outcomes, i.e., missed infectious disease (ID) specialist appointments, other missed clinic and lab appointments, and self-reported adherence were assessed over 2&#xa0;years. A logistic regression and Poisson regression model within a generalized linear mixed model framework was used to analyze the association between predictors, treatment adherence outcomes, and interactions with time.</p> Results <p>Following re-engagement in care, increased alcohol use was associated with lower odds of antiretroviral therapy adherence over time, increased odds of missing ID specialist appointments, and missed clinic/lab appointments. Self-efficacy was associated with better medication adherence and fewer missed ID specialist appointments over time. Similarly, both motivation and patient/provider communication were associated with fewer missed ID specialist and clinic/lab appointments over time. Having private health insurance was also associated with less missed clinic/lab appointments.</p> Conclusion <p>Findings suggest alcohol use reduction interventions could improve treatment outcomes in this population. Additionally, interventions targeting patient-provider communication and patient self-efficacy and motivation may enhance retention following re-engagement in care.</p>

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Antiretroviral Therapy Adherence and Clinic Attendance Over Time Among People in Argentina Living with HIV and Lost to Care

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月24日

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  • Omar Sued,
  • Violeta J. Rodriguez,
  • Stephen M. Weiss,
  • Maria Luisa Alcaide,
  • Diego Cecchini,
  • Pedro Cahn,
  • Isabel Cassetti,
  • Chloe J. Kaminsky,
  • Deborah L. Jones

摘要

Background

Although Argentina provides access to no cost HIV care, treatment adherence and retention in care remain suboptimal. This study aimed to explore factors associated with self-reported adherence and appointment attendance over time.

Method

Participants (N = 360) were people living with HIV (PLWH) that were lost to care (i.e., three missed pharmacy pickups in the last 6 months, or had not attended a physician visit in the last 12 months). Participants were recruited from seven HIV clinics in four urban centers in Argentina and re-engaged in care. Demographic variables, predictors, i.e., alcohol use, self-efficacy, motivation, patient-provider communication, insurance type (private/public), and outcomes, i.e., missed infectious disease (ID) specialist appointments, other missed clinic and lab appointments, and self-reported adherence were assessed over 2 years. A logistic regression and Poisson regression model within a generalized linear mixed model framework was used to analyze the association between predictors, treatment adherence outcomes, and interactions with time.

Results

Following re-engagement in care, increased alcohol use was associated with lower odds of antiretroviral therapy adherence over time, increased odds of missing ID specialist appointments, and missed clinic/lab appointments. Self-efficacy was associated with better medication adherence and fewer missed ID specialist appointments over time. Similarly, both motivation and patient/provider communication were associated with fewer missed ID specialist and clinic/lab appointments over time. Having private health insurance was also associated with less missed clinic/lab appointments.

Conclusion

Findings suggest alcohol use reduction interventions could improve treatment outcomes in this population. Additionally, interventions targeting patient-provider communication and patient self-efficacy and motivation may enhance retention following re-engagement in care.