title: Antiretroviral Therapy Use, Medication Adherence, and Viral Suppression Among PLWHA with Panic Symptoms.
abstract: Panic symptoms are prevalent among PLWHAs, yet few studies have examined their relationship with HIV outcomes. Using data from an observational cohort study in Baltimore, MD, we examined the association between panic symptoms and antiretroviral therapy (ART) use, medication adherence, and viral suppression. Data were analyzed using generalized estimating equations and adjusted for age, sex, race/ethnicity, cocaine and/or heroin use, clinic enrollment time, alcohol use, and depressive symptoms. Between June 2010 and September 2012, 1195 individuals participated in 2080 audio computer assisted interviews; 9.9 % (n = 118) of individuals endorsed current panic symptoms. In multivariate analysis, panic symptoms were associated with decreased ART use (IRR 0.94; p = 0.05). Panic symptoms were neither associated with medication adherence nor viral suppression. These findings were independent of depressive symptoms and substance use. Panic symptoms are under-recognized in primary care settings and present an important barrier to ART use. Further studies investigating the reasons for this association are needed.
authors.affiliation: Department of Medicine, The Brooklyn Hospital Center, 121 Dekalb Avenue, Maynard Building, Suite 14D, Brooklyn, NY, 11201, USA. tss9008@nyp.org.
authors.forename: Tanyka Suzanne
authors.initials: TS
authors.lastname: Sam
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Hutton
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Lau
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: McCaul
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Keruly
authors.affiliation: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.|Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Moore
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Geetanjali
authors.initials: G
authors.lastname: Chander
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000523:psychology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015142:Baltimore; D018791:CD4 Lymphocyte Count; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology* / Q000821:virology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010200:Panic; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000150:complications; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: Antiretroviral therapy use; Medication adherence; Panic symptoms; Psychiatric disorder; Viral suppression