Relationship of race-, sexual orientation-, and HIV-related discrimination with adherence to HIV treatment: a pilot study

Abstract

Adherence to highly active antiretroviral therapy (HAART) must be close to perfect in order to maintain suppression of HIV viral load, and to prevent the development of drug resistant strains of HIV. People living with HIV (PLWH) often report low levels of adherence. One variable that has been linked to poor adherence is perceived discrimination; however, research has generally not considered the possible unique effects of different types of discrimination on adherence. The present pilot study aimed to examine the association of three types of discrimination (due to HIV+ status, race, or sexual orientation) with adherence among 57 PLWH. Logistic regression analyses were conducted to demonstrate the relationships between each type of discrimination and self-reported adherence. Racial discrimination significantly predicted lower adherence levels, whereas sexual orientation- and HIV-related discrimination did not. Results underscore the importance of addressing discrimination issues, specifically racial, when designing interventions to improve adherence to HAART.

Longitudinal Relationships Between Antiretroviral Treatment Adherence and Discrimination Due to HIV-Serostatus, Race, and Sexual Orientation Among African–American Men with HIV

“…Consistent with prior research supporting an association between discrimination and adherence [17, 18, 28, 29], a greater number of discrimination experiences were associated with worse treatment adherence over 6 months.…”

“…However, only a few small studies have examined the effects of the layering of stigma from multiple devalued social categories. In a study of 57 people with HIV (47% Black), perceived racism was the only significant correlate of self-reported antiretroviral treatment nonadherence in multivariate analyses controlling for discrimination due to HIV-serostatus and sexual orientation [28]. A study of 101 people with HIV (45% Black) found that perceived discrimination in health care due to social class was significantly associated with self-reported antiretroviral treatment nonadherence and missed medical appointments, whereas perceived discrimination due to race/ethnicity was not significantly related to either HIV care measure [29].…”

Key Barriers to Medication Adherence in Survivors of Strokes and Transient Ischemic Attacks

“…[30][31][32][33] Amongst certain minorities, there is a history of discrimination that continues to inform current perceptions about health care and can lead to distrust in treatments espoused by the health care system. 34 Interestingly, in our subgroup analysis, we found that perceived discrimination was a barrier to medication adherence in Hispanics, but not in African Americans.…”

Factors Associated with Nonadherence to Antiretroviral Therapy in HIV-Positive Smokers

“…Additionally, the ART adherence measure, which is a clinically valid measure utilized in a variety of settings, lacks specificity, which can result in an overestimation of adherence rates. [26][27][28][29][30] Furthermore, information on specific illicit drugs used by participants was not collected. Therefore, we were unable to assess differences between specific agents and ART adherence.…”