title: Predictors of HIV Care Engagement, Antiretroviral Medication Adherence, and Viral Suppression Among People Living with HIV Infection in St. Petersburg, Russia.
abstract: Over 1 million HIV infections have been diagnosed in Russia, and HIV care uptake and viral suppression are very low. 241 HIV-positive individuals in St. Petersburg were enrolled through social networks, provided blood for viral load testing, and completed measures of medication-taking adherence, readiness, and self-efficacy; psychosocial well-being; and substance use. Outcomes included attending an HIV care appointment in the past 6 months, >90% ART adherence, and undetectable viral load. 26% of participants had no recent care appointment, 18% had suboptimal adherence, and 56% had detectable viral load. Alcohol use consistently predicted all adverse health outcomes. Having no recent care visit was additionally associated with being single and greater past-month drug injection frequency. Poor adherence was additionally predicted by lower medication-taking self-efficacy and lower anxiety. Detectable viral load was additionally related to younger age. Comprehensive interventions to improve HIV care in Russia must address substance abuse, anxiety, and medication-taking self-efficacy.
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Center for AIDS Intervention Research (CAIR), 2071 North Summit Avenue, Milwaukee, WI, 53202, USA. yuri@mcw.edu.|Botkin Hospital for Infectious Diseases, Interdisciplinary Center for AIDS Research and Training (ICART), St. Petersburg, Russia. yuri@mcw.edu.
authors.forename: Yuri A
authors.initials: YA
authors.lastname: Amirkhanian
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Center for AIDS Intervention Research (CAIR), 2071 North Summit Avenue, Milwaukee, WI, 53202, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kelly
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Center for AIDS Intervention Research (CAIR), 2071 North Summit Avenue, Milwaukee, WI, 53202, USA.
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: DiFranceisco
authors.affiliation: Botkin Hospital for Infectious Diseases, Interdisciplinary Center for AIDS Research and Training (ICART), St. Petersburg, Russia.
authors.forename: Anna V
authors.initials: AV
authors.lastname: Kuznetsova
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Center for AIDS Intervention Research (CAIR), 2071 North Summit Avenue, Milwaukee, WI, 53202, USA.
authors.forename: Sergey S
authors.initials: SS
authors.lastname: Tarima
authors.affiliation: Botkin Hospital for Infectious Diseases, Interdisciplinary Center for AIDS Research and Training (ICART), St. Petersburg, Russia.
authors.forename: Alexey A
authors.initials: AA
authors.lastname: Yakovlev
authors.affiliation: Botkin Hospital for Infectious Diseases, Interdisciplinary Center for AIDS Research and Training (ICART), St. Petersburg, Russia.
authors.forename: Vladimir B
authors.initials: VB
authors.lastname: Musatov
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000150:complications* / Q000523:psychology; D003266:Continuity of Patient Care; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D000076522:Retention in Care; D012309:Risk-Taking; D012426:Russia / Q000453:epidemiology; D020377:Self Efficacy; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology; D019562:Viral Load / Q000187:drug effects*
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV care linkage and retention; HIV medical care; HIV services; HIV-positive; Persons living with HIV; Russia