title: Informal HIV Caregiver Proxy Reports of Care Recipients' Treatment Adherence: Relationship Factors Associated with Concordance with Recipients' Viral Suppression.
abstract: To explore the role of informal caregivers in adherence, we compared adherence reports by caregivers to those of care recipients. We identified individual-level and relationship factors associated with agreement between caregivers' reports of recipients' adherence and assessed viral suppression. Participants were care recipients, who were on ART and had ever injected drugs, and their caregivers (N = 258 dyads). Nearly three-fourths of caregivers' reports of recipients' ART adherence agreed with recipients' viral suppression status. Agreement was associated with recipient age and expressing affection or gratitude to the caregiver, caregiver's having been close to someone who died of HIV/AIDS, and caregiver's fear of caregiving-related HIV (re)infection, while it was negatively associated with recipient's limited physical functioning. Our findings support the utility of caregiver proxy reports of care recipients' ART adherence and suggest ways to identify and promote HIV caregiver attention to and support of this vulnerable population's ART adherence.
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 745, Baltimore, MD, 21205, USA. aknowlt1@jhu.edu.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Knowlton
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 745, Baltimore, MD, 21205, USA.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Mitchell
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 745, Baltimore, MD, 21205, USA.
authors.forename: Allysha C
authors.initials: AC
authors.lastname: Robinson
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 745, Baltimore, MD, 21205, USA.
authors.forename: Trang Q
authors.initials: TQ
authors.lastname: Nguyen
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 745, Baltimore, MD, 21205, USA.
authors.forename: Sarina
authors.initials: S
authors.lastname: Isenberg
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Denison
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D019727:Proxy; D013315:Stress, Psychological; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000208:ethnology; D011795:Surveys and Questionnaires; D019562:Viral Load / Q000187:drug effects*
chemical_list: D044966:Anti-Retroviral Agents
keywords: Antiretroviral therapy adherence; Black/African American; Informal HIV caregiving; Injection drug/substance abuse; Measurement concordance/agreement