title: Correlates of Combination Antiretroviral Adherence Among Recently Diagnosed Older HIV-Infected Adults Between 50 and 64 years.
abstract: Optimal adherence to combination antiretroviral therapy is essential to the health of older people living with HIV (PLWH), however, the literature on adherence and aging is limited. Using Medicaid data from 29 states (N = 5177), we explored correlates of optimal adherence among older PLWH. The prevalence of optimal adherence was low (32 %) in this study. Males were more adherent than females (APR = 1.11, 95 % CI 1.02-1.21, P = 0.0127); persons with three or more co-morbidities (APR = 0.67, 95 % CI 0.60-0.74, P < 0.001), two co-morbidities (APR = 0.86, 95 % CI 0.75-0.98, P = 0.0319) and one co-morbidity (APR = 0.82, 95 % CI 0.73-0.92, P = 0.0008) were less adherent than those without any co-morbidity; and residents of rural areas (APR = 0.90, 95 % CI 0.63-0.98, P = 0.0385) and small metropolitan areas (APR = 0.82, 95 % CI 0.72-0.94, P = 0.0032) were less adherent than residents of large metropolitan areas. There were no racial differences in optimal adherence. Targeted interventions that provide adherence support, case management, and peer navigation services may be of benefit in achieving optimal adherence in this population.
authors.affiliation: Department of Community Health and Preventive Medicine, Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive SW, NCPC 214, Atlanta, GA, USA. winston_abara@yahoo.com.
authors.forename: Winston E
authors.initials: WE
authors.lastname: Abara
authors.affiliation: Department of Community Health and Preventive Medicine, Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive SW, NCPC 214, Atlanta, GA, USA.
authors.forename: Oluwatoyosi A
authors.initials: OA
authors.lastname: Adekeye
authors.affiliation: National Center for Primary Care, Morehouse School of Medicine, 720 Westview Drive SW, NCPC 214, Atlanta, GA, USA.
authors.forename: Junjun
authors.initials: J
authors.lastname: Xu
authors.affiliation: Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive SW, NCPC 214, Atlanta, GA, USA.
authors.forename: Harry J
authors.initials: HJ
authors.lastname: Heiman
authors.affiliation: National Center for Primary Care, Morehouse School of Medicine, 720 Westview Drive SW, NCPC 214, Atlanta, GA, USA.
authors.forename: George
authors.initials: G
authors.lastname: Rust
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D008484:Medicaid; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D013223:Statistics as Topic; D014481:United States
chemical_list: D019380:Anti-HIV Agents
keywords: Aging; Antiretroviral adherence; HIV/AIDS; Older adults; People living with HIV