期刊
AIDS PATIENT CARE AND STDS
卷 23, 期 4, 页码 259-266出版社
MARY ANN LIEBERT, INC
DOI: 10.1089/apc.2008.0210
关键词
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资金
- United States National Institute of Mental Health [R01-MH62965, K23-MH076671]
- American Foundation for AIDS Research [106884-42-RFBR]
HIV is a chronic, life-threatening illness that necessitates regular and consistent medical care. Childhood sexual abuse (CSA) is a common experience among HIV-positive adults and may interfere with treatment utilization. This study examined rates and correlates of treatment utilization among HIV-positive adults with CSA enrolled in a coping intervention trial in New York City. The baseline assessment included measures of treatment utilization, mental health, substance abuse, and other psychosocial factors. In 2002-2004, participants (50% female, 69% African-American, M 42.3 +/- 6.8 years old) were recruited. Nearly all (99%) received HIV medical care. However, 20% had no outpatient visits and 24% sought emergency services in the past 4 months. Among 184 participants receiving antiretroviral therapy (ART), 22% were less than 90% adherent in the past week. In a multivariable logistic regression model, no outpatient treatment was associated with African American race (AOR 3.46 [1.42-8.40]), poor social support (AOR - 1.59 [1.03-2.45]), and abstinence from illicit drug use (AOR - 0.37 [0.16-0.85]). Emergency service utilization was associated with HIV symptoms (AOR - 2.30 [1.22-4.35]), binge drinking (AOR - 2.92 (1.18-7.24)), and illicit drug use (AOR - 1.98 [1.02-3.85]). Poor medication adherence was associated with trauma symptoms (AOR - 2.64 [1.07-6.75]) and poor social support (AOR - - 1.82 [1.09-2.97]). In sum, while participants had access to HIV medical care, a sizable minority did not adhere to recommended guidelines and thus may not be benefiting optimally from treatment. Interventions targeting HIV-positive adults with CSA histories may need to address trauma symptoms, substance abuse, and poor social support that interfere with medical treatment utilization and adherence.
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