title: The role of HIV serostatus disclosure in antiretroviral medication adherence.
abstract: This study examined the relationship between HIV serostatus disclosure and adherence to antiretroviral therapy (ART). The study was conducted with 215 HIV-seropositive patients who demonstrated poor adherence (<80%) and who were in serodiscordant relationships. Participants completed self-report measures regarding HIV serostatus disclosure and reasons for missing ART doses, as well as electronic monitoring of ART adherence (MEMS caps). Overall, 19% of the sample reported missing medication doses in the last two months due to concerns regarding serostatus disclosure. Participants who reported greater serostatus disclosure to others demonstrated higher rates of adherence, and this relationship remained after controlling for other explanatory variables. The relationship between disclosure and adherence was not mediated by practical support for adherence from others. Interventions to improve ART adherence should address the role of serostatus disclosure by providing patients with skills to maintain adherence in contexts of non-disclosure and to make informed choices regarding selective disclosure.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York 10032, USA. mjs2114@columbia.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stirratt
authors.forename: Robert H
authors.initials: RH
authors.lastname: Remien
authors.forename: Anna
authors.initials: A
authors.lastname: Smith
authors.forename: Olivia Q
authors.initials: OQ
authors.lastname: Copeland
authors.forename: Curtis
authors.initials: C
authors.lastname: Dolezal
authors.forename: Daniel
authors.initials: D
authors.lastname: Krieger
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006679:HIV Seropositivity / Q000523:psychology*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D012650:Self Disclosure; D012944:Social Support; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents