Journal
AIDS AND BEHAVIOR
Volume 22, Issue 3, Pages 791-799Publisher
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10461-016-1638-9
Keywords
Russia; Persons living with HIV; HIV-positive; HIV medical care; HIV services; HIV care linkage and retention
Funding
- National Institute of Mental Health [R01-MH098729, P30-MH52776, R21-MH102193]
- Russian Foundation for Basic Research [13-06-91440]
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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.
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