title: Abuse and resilience in relation to HAART medication adherence and HIV viral load among women with HIV in the United States.
abstract: Abuse is highly prevalent among HIV+ women, leading to behaviors, including lower adherence to highly active antiretroviral therapy (HAART) that result in poor health outcomes. Resilience (functioning competently despite adversity) may buffer the negative effects of abuse. This study investigated how resilience interacted with abuse history in relation to HAART adherence, HIV viral load (VL), and CD4+ cell count among a convenience sample of 138 HIV+ women from the Ruth M. Rothstein CORE Center/Cook County Health and Hospital Systems site of the Women's Interagency HIV Study (WIHS). Resilience was measured by the 10-item Connor-Davidson Resilience Scale (CD-RISC). HAART adherence (≥95% vs. <95% self reported usage of prescribed medication) and current or prior sexual, physical, or emotional/domestic abuse, were reported during structured interviews. HIV viral load (≥20 vs. <20 copies/mL) and CD4+ count (200 vs. <200 cells/mm) were measured with blood specimens. Multiple logistic regressions, controlling for age, race, income, enrollment wave, substance use, and depressive symptoms, indicated that each unit increase in resilience was significantly associated with an increase in the odds of having ≥95% HAART adherence and a decrease in the odds of having a detectable viral load. Resilience-Abuse interactions showed that only among HIV+ women with sexual abuse or multiple abuses did resilience significantly relate to an increase in the odds of ≥95% HAART adherence. Interventions to improve coping strategies that promote resilience among HIV+ women may be beneficial for achieving higher HAART adherence and viral suppression.
authors.affiliation: 1 Department of Psychology, Boston University , Boston, Massachusetts.
authors.forename: Sannisha
authors.initials: S
authors.lastname: Dale
authors.forename: Mardge
authors.initials: M
authors.lastname: Cohen
authors.forename: Kathleen
authors.initials: K
authors.lastname: Weber
authors.forename: Ruth
authors.initials: R
authors.lastname: Cruise
authors.forename: Gwendolyn
authors.initials: G
authors.lastname: Kelso
authors.forename: Leslie
authors.initials: L
authors.lastname: Brody
mesh_terms: D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000523:psychology / Q000821:virology*; D006801:Humans; D016015:Logistic Models; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D055500:Resilience, Psychological; D012742:Sex Offenses; D013179:Spouse Abuse / Q000523:psychology*; D019966:Substance-Related Disorders / Q000150:complications; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D019562:Viral Load