title: Self-perception of body fat changes and HAART adherence in the Women's Interagency HIV Study.
abstract: To determine the association of self-perceived fat gain or fat loss in central and peripheral body sites with adherence to highly active antiretroviral therapy (HAART) in HIV-seropositive women. 1,671 women from the Women's Interagency HIV Study who reported HAART use between April 1999 and March 2006 were studied. Adherence was defined as report of taking HAART >/= 95% of the time during the prior 6 months. Participant report of any increase or decrease in the chest, abdomen, or upper back in the prior 6 months defined central fat gain and central fat loss, respectively. Report of any increase or decrease in the face, arms, legs or buttocks in the prior 6 months defined peripheral fat gain or peripheral fat loss. Younger age, being African-American (vs. White non-Hispanic), a history of IDU, higher HIV RNA at the previous visit, and alcohol consumption were significant predictors of HAART non-adherence (P < 0.05). After multivariate adjustment, self-perception of central fat gain was associated with a 1.5-fold increased odds of HAART non-adherence compared to no change. Self-perception of fat gain in the abdomen was the strongest predictor of HAART non-adherence when the individual body sites were studied. Women who perceive central fat gain particularly in the abdomen are at risk for decreased adherence to HAART despite recent evidence to suggest that HIV and specific antiretroviral drugs are more commonly associated with fat loss than fat gain.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, 2233 Wisconsin Avenue, NW Suite #214, Washington, DC, 20007, USA. mwp23@georgetown.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Plankey
authors.forename: Peter
authors.initials: P
authors.lastname: Bacchetti
authors.forename: Chengshi
authors.initials: C
authors.lastname: Jin
authors.forename: Barbara
authors.initials: B
authors.lastname: Grimes
authors.forename: Charles
authors.initials: C
authors.lastname: Hyman
authors.forename: Mardge
authors.initials: M
authors.lastname: Cohen
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Howard
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Tien
mesh_terms: D000328:Adult; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D050218:Body Fat Distribution / Q000523:psychology*; D001828:Body Image; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D055118:Medication Adherence / Q000523:psychology*; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies