title: Examining Adherence Among Challenging Patients in Public and Private HIV Care in Argentina.
abstract: Treatment engagement, retention and adherence to care are required for optimal HIV outcomes. Yet, patients may fall below the treatment recommendations for achieving undetectable viral load or not be retained in care. This study examined the most challenging patients in Buenos Aires, Argentina, those non-adherent to HIV care. Men (n = 61) and women (n = 59) prescribed antiretrovirals (ARVs) and non-adherent to treatment in the prior 3-6 months were enrolled and assessed regarding adherence, knowledge, motivation and attitudes regarding treatment. Private clinic patients had lower viral load and higher self-reported adherence than public clinic patients. Motivations to be adherent and positive beliefs regarding ARVs were associated with increased adherence in public clinic participants. Increased self-efficacy was associated with increased adherence among participants from both clinics. Results support patient and provider interventions that strengthen the characteristics supporting adherence, engagement and retention in public and private clinic settings.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Miami, FL, 33136, USA, djones@med.miami.edu.
authors.forename: Deborah
authors.initials: D
authors.lastname: Jones
authors.forename: Ryan
authors.initials: R
authors.lastname: Cook
authors.forename: Diego
authors.initials: D
authors.lastname: Cecchini
authors.forename: Omar
authors.initials: O
authors.lastname: Sued
authors.forename: Lina
authors.initials: L
authors.lastname: Bofill
authors.forename: Stephen
authors.initials: S
authors.lastname: Weiss
authors.forename: Drenna
authors.initials: D
authors.lastname: Waldrop-Valverde
authors.forename: Maria R
authors.initials: MR
authors.lastname: Lopez
authors.forename: Andrew
authors.initials: A
authors.lastname: Spence
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001118:Argentina / Q000453:epidemiology; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence / Q000208:ethnology / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care; D017149:Private Sector; D017150:Public Sector; D020377:Self Efficacy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D019562:Viral Load; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents