Psychosocial burdens negatively impact HIV antiretroviral adherence in gay, bisexual, and other men who have sex with men aged 50 and older

• Published in: AIDS care Vol. 26; no. 11; pp. 1426 - 1434
• Main Authors: Halkitis, Perry N., Perez-Figueroa, Rafael Eduardo, Carreiro, Timothy, Kingdon, Molly J., Kupprat, Sandra A., Eddy, Jessica
• Format: Journal Article
• Language: English
• Published: Abingdon Routledge 02.11.2014; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Acquired Immune Deficiency Syndrome; adherence; Adult and adolescent clinical studies; Age Factors; Aged; Ageing; Aging; AIDS/HIV; Anti-Retroviral Agents - therapeutic use; Antiretroviral drugs; Biological and medical sciences; Bisexuality; Bisexuality - psychology; Compulsivity; Cost of Illness; Cross-Sectional Studies; Depression; Depression - diagnosis; Depression - psychology; gay and bisexual; Gays & lesbians; Health Behavior; HIV; HIV Infections - drug therapy; HIV Infections - psychology; HIV-stigma; Homosexuality; Homosexuality, Male - psychology; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Male; Males; Medical sciences; Medication Adherence - psychology; Medications; Middle Aged; Miscellaneous; Mood disorders; Prejudice; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk-Taking; Sexual behavior; Sexual Behavior - psychology; sexual compulsivity; Sexual intercourse; Socioeconomic Factors; Stigma; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - psychology; Teaching; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Social environment; Antiretroviral agent; Homosexuality; Senescence; Stigma; Mental health; Pharmacotherapy; Male; gay and bisexual; sexual compulsivity; Drug compliance; Antiviral; Public health; Mood disorder; Immunopathology; adherence; Retroviridae; Depression; AIDS; Bisexuality; Psychosocial factor; Immune deficiency; Lentivirus; Adhesion; Infection; Virus; HIV-stigma; Treatment; HIV; Viral disease; Compulsion; Human immunodeficiency virus; aging; depression
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2014.921276

We sought to characterize HIV antiretroviral therapy (ART) adherence and psychosocial correlates of adherence in a sample of gay, bisexual, and other non-gay or -bisexual identified men who have sex with men aged 50 and over. As part of a cross-sectional study we recruited a community-based sample of 199 men and assessed adherence to current ART medications along four domains: (1) missing doses in the past 4 days, (2) taking doses on the specified schedule in the past 4 days, (3) following instructions about how to take the medications (e.g., to take medications with food), and (4) missing doses in the last weekend. A total adherence score was also computed. Bivariable analyses indicated negative associations between depression, sexual compulsivity, and HIV-related stigma with each of the individual adherence variables and the composite adherence score, while an older age was found to be protective. In multivariable analyses, controlling for age and educational attainment, a higher likelihood of missing doses and failing to follow instructions were related to higher levels of HIV-related stigma, while dosing off-schedule and missing doses on weekends was associated with higher levels of sexual compulsivity. These results indicate that psychosocial burdens undermine the adherence behaviors of older HIV-positive sexual minority men. Programming and services to address this compromising health behavior must embrace a holistic approach to health as informed by syndemics theory, while attending to the developmental and age-specific needs of older men.