title: Social position, gender role, and treatment adherence among Colombian women living with HIV/AIDS: social determinants of health approach.
abstract: OBJECTIVE
  To assess and analyze the associations between adherence to treatment and social position in women living with HIV/AIDS.
  
  
  METHODS
  A cross-sectional, descriptive, correlational study among 269 Colombian women was conducted. Participants completed three questionnaires: a socio-demographic and clinical characteristics survey, a treatment adherence scale, and a social position survey.
  
  
  RESULTS
  Women of low social position had a significantly higher probability of low treatment adherence (OR = 5.651, P < 0.0001), and the majority of social position variables measured had a significant effect on adherence. A general model considering the variables 'type of national health care plan' ('contributive,' 'subsidized,' or, in the case of vinculadas or the uninsured, 'none'); 'having HIV-positive children'; and 'level of viral load' was statistically reliable in predicting study participants' treatment adherence. Membership in the subsidized plan or being uninsured had a greater effect on the probability of low adherence than membership in the contributive plan (OR = 3.478, P < 0.0001). Univariate regression analyses confirmed that women with HIV-positive children and a viral load > 400 copies/ml were more likely to have low adherence than women without those characteristics (OR = 2.395, P = 0.0274 and OR = 2.178, P = 0.0050, respectively).
  
  
  CONCLUSIONS
  Improving women's adherence to HIV/AIDS treatment in Colombia would require eliminating barriers to national health care system and comprehensive health care services and implementing programs that take into account women's role as maternal caregivers The findings underscore the need to integrate variables related to gender inequality and social position in treatment adherence analysis, as advocated in the social determinants of health approach.
authors.affiliation: Department of Social Sciences, Pontificia Universidad Javeriana, Cali, Colombia. marceq@javerianacali.edu.co
authors.forename: Marcela
authors.initials: M
authors.lastname: Arrivillaga
authors.forename: Michael
authors.initials: M
authors.lastname: Ross
authors.forename: Bernardo
authors.initials: B
authors.lastname: Useche
authors.forename: Martha Lucia
authors.initials: ML
authors.lastname: Alzate
authors.forename: Diego
authors.initials: D
authors.lastname: Correa
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D003105:Colombia; D003430:Cross-Sectional Studies; D005260:Female; D005783:Gender Identity; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult; D016903:Drug Monitoring