Correlates of Adherence Among Rural Indian Women Living With HIV/AIDS

Nyamathi, Adeline; Salem, Benissa E.; Ernst, E.; Keenan, Colleen; Suresh, P.; Sinha, Sanjeev; Ganguly, Kalyan K.; Ramakrishnan, Padma; Liu, Yihang

doi:10.1080/15381501.2012.735164

Cited by 15 publications

(18 citation statements)

References 43 publications

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“…The impact of the program on the physical health of WLA was also reported by the women in terms of CD4 counts and body weight and concur with other research studies (Nyamathi, Hanson, et al, 2012; Nyamathi, Salem, Ernst, Keenan, Suresh, Sinha, Ganguly, Ramakrishnan, & Liu, 2012). …”

Section: Discussionsupporting

confidence: 89%

ASHA-Life Intervention Perspectives Voiced by Rural Indian Women Living With AIDS

Nyamathi

Srivastava

Carpenter

et al. 2015

Health Care for Women International

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In this focus group study, we explored the experiences of 16 rural women living with AIDS (WLA) who participated in the Asha-Life (AL) intervention to gain an understanding of the environmental, psychosocial and cultural impact of the AL on their lives. Four themes emerged among AL participants: a) The Importance of Tangible Support, b) Need for Social Support, c) Ongoing Challenges to Accessing Antiretroviral Therapy (ART), and d) Perspectives on Future Programs. Our research findings support the development of future programs targeting mother-child dyads which emphasize nutritional knowledge, while reducing barriers to receiving ART, and physical, emotional, and financial support.

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Section: Discussionsupporting

confidence: 89%

ASHA-Life Intervention Perspectives Voiced by Rural Indian Women Living With AIDS

Nyamathi

Srivastava

Carpenter

et al. 2015

Health Care for Women International

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“…An investigation by Nyamathi et al [79] used measures of internalized stigma, enacted stigma, vicarious stigma (i.e., hearing stories of enacted stigma targeting others), and felt stigma (i.e., perception of stigma in the community). In this investigation, the authors found that although internalized and vicarious stigma had univariate associations with adherence, as assessed by observed pill counts, neither was significantly associated with adherence in multivariate analyses, after including depression and adherence support from parents.…”

Section: Studies Using Multiple Measures Of Stigmamentioning

confidence: 99%

The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

2015

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This paper provides a review of the quantitative literature on HIV-related stigma and medication adherence, including: (1) synthesis of the empirical evidence linking stigma to adherence, (2) examination of proposed causal mechanisms of the stigma and adherence relationship, and (3) methodological critique and guidance for future research. We reviewed 38 studies reporting either cross-sectional or prospective analyses of the association of HIV-related stigma to medication adherence since the introduction of antiretroviral therapies (ART). Although there is substantial empirical evidence linking stigma to adherence difficulties, few studies provided data on psychosocial mechanisms that may account for this relationship. Proposed mechanisms include: (a) enhanced vulnerability to mental health difficulties, (b) reduction in self-efficacy, and (c) concerns about inadvertent disclosure of HIV status. Future research should strive to assess the multiple domains of stigma, use standardized measures of adherence, and include prospective analyses to test mediating variables.

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“…Social support has been associated with higher adherence (Nyamathi et al, 2012; Shah et al, 2007), and depression is linked with poorer adherence (Anuradha et al, 2013; Nyamathi et al, 2012; Sarna et al, 2008). Although stigma has been associated with poor adherence in many settings (Kingori et al, 2012; Rao, Kekwaletswe, Hosek, Martinez, & Rodriguez, 2007; Rintamaki, Davis, Skripkauskas, Bennett, & Wolf, 2006; Vyankandondera et al, 2013) and noted as a barrier in qualitative studies (Joglekar et al, 2011; Kumarasamy et al, 2005), it has not been quantitatively assessed in India.…”

Section: Introductionmentioning

confidence: 99%

Antiretroviral therapy adherence measurement in non-clinical settings in South India

et al. 2014

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Optimal adherence to antiretroviral therapy (ART) is key to viral suppression, but may be impeded by psychosocial consequences of HIV-infection such as stigma and depression. Measures of adherence in India have been examined in clinic populations, but little is known about the performance of these measures outside clinical settings. We conducted a cross-sectional study of 151 Tamil-speaking people living with HIV/AIDS (PLHA) in India recruited through HIV support networks and compared single item measures from the Adult AIDS Clinical Trial Group (AACTG) scale, a visual analog scale (VAS), and a question on timing of last missed dose. Depression was measured using the Major Depression Inventory (MDI) and HIV-related stigma was measured using an adaptation of the Berger Stigma Scale. Mean age was 35.6 years (SD±5.9); 55.6% were male; mean MDI score was 11.9 (SD±9.1); and mean stigma score was 67.3 (SD±12.0). Self-reported perfect adherence (no missed doses) was 93.3% using the AACTG item, 87.1% using last missed dose, and 83.8% using the VAS. The measures had moderate agreement with each other (kappa 0.45 - 0.57). Depression was associated with lower adherence irrespective of adherence measure used, and remained significantly associated in multivariable analyses adjusting for age and marital status. Stigma was not associated with adherence irrespective of the measure used. The VAS captured the greatest number of potentially non-adherent individuals and may be useful for identifying PLHA in need of adherence support. Given the consistent and strong association between poorer adherence and depression, programs that jointly address adherence and mental health for PLHA in India may be more effective than programs targeting only one.

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Correlates of Adherence Among Rural Indian Women Living With HIV/AIDS

Cited by 15 publications

References 43 publications

ASHA-Life Intervention Perspectives Voiced by Rural Indian Women Living With AIDS

ASHA-Life Intervention Perspectives Voiced by Rural Indian Women Living With AIDS

The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

Antiretroviral therapy adherence measurement in non-clinical settings in South India

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