title: A binational study of patient-initiated changes to antiretroviral therapy regimen among HIV-positive Latinos living in the Mexico-U.S. border region.
abstract: Research is lacking on factors associated with antiretroviral therapy (ART) sub-optimal adherence among U.S. Latinos, who are disproportionately affected by HIV and face substantial health care barriers. We examined self-reported, patient-initiated changes to ART (i.e., made small/major changes from the antiretroviral drugs prescribed) among HIV-positive Latinos. Trained interviewers administered surveys to 230 participants currently on ART in San Diego, U.S. and Tijuana, Mexico. We identified factors independently associated with ART changes. Participants were Spanish-language dominant (86%), mean age of 41 years, male (77%), and born in Mexico (93%). Patient-initiated changes to ART were reported in 43% of participants. Being female, having ≥1 sexual partner (past 3 months), ≤6 years since HIV diagnosis and poor health were associated with increased odds of ART changes. Findings raise concern about sub-optimal adherence among this binational population. Longitudinal studies are needed to further explore adherence barriers and avenues for intervention.
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, 92093-0927, USA. mzuniga@ucsd.edu
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Zúñiga
authors.forename: Fátima
authors.initials: F
authors.lastname: Muñoz
authors.forename: Justine
authors.initials: J
authors.lastname: Kozo
authors.forename: Estela
authors.initials: E
authors.lastname: Blanco
authors.forename: Rosana
authors.initials: R
authors.lastname: Scolari
mesh_terms: D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D002140:California; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D008800:Mexico; D008875:Middle Aged; D057240:Patient Preference; D057566:Self Report; D017678:Sex Distribution; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D044966:Anti-Retroviral Agents