title: Association of disclosure of HIV status with medication adherence.
abstract: Disclosure may affect adherence to antiretroviral treatment. In a medication adherence program, this cross-sectional study describes disclosure, perceived reaction after disclosure, living situations, and the relationship of disclosure with antiretroviral adherence.
  
  
  
  A combination of a questionnaire to measure disclosure and longitudinal electronic monitoring of medication adherence was used.
  
  
  
  A total of 103 out of 159 eligible patients gave informed consent. The characteristics differed between participants and nonparticipants (race, education, sexual orientation, medication adherence). Thirteen participants did not disclose their HIV status. Seventy-three (81%) participants judged the reaction after disclosure positive. Among the 62 participants cohabiting, 52% disclosed to all co-residents. Adherence was high (median 100%). HIV disclosure was negatively associated with adherence, when disclosing to the mother (OR=2.46, p-value=0.086) and to siblings (OR=2.89, p-value=0.029). Living alone was associated to a lower adherence than cohabitation (Rate Ratio=1.42, p-value=0.007).
  
  
  
  HIV disclosure and adherence are sensitive issues, which may explain the reason for refusal. Nonparticipants may be those with the most difficulties disclosing.
  
  
  
  An unbiased collection of sensitive information, as HIV disclosure, is a difficult task. A cohort design, with research data collected systematically by a trusted healthcare provider, may better describe the association between adherence and disclosure.
authors.affiliation: Community pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland; Community pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Rotzinger
authors.affiliation: Department of Ambulatory care & Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Isabella
authors.initials: I
authors.lastname: Locatelli
authors.affiliation: Community pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Reymermier
authors.affiliation: Community pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Amico
authors.affiliation: Community pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland; Community pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bugnon
authors.affiliation: Infectious Disease Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Cavassini
authors.affiliation: Community pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland; Community pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne, Lausanne, Switzerland. Electronic address: marie-paule.schneider@hospvd.ch.
authors.forename: Marie Paule
authors.initials: MP
authors.lastname: Schneider
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006679:HIV Seropositivity / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence; D012650:Self Disclosure; D057545:Social Stigma; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013557:Switzerland; D014342:Truth Disclosure
chemical_list: D019380:Anti-HIV Agents
keywords: Disclosure; HIV; Medication adherence; Refusal to participate; Social support