Impact of physician appointment on HAART adherence among HIV/AIDS population in a public clinic for HIV/AIDS, in Houston, Texas; a cross-sectional design using logistic regression modeling
Background: Adherence to HAART remains an issue in HIV/AIDS therapeutics adversely impacting morbidities such as AIDS related dementia and HIV encephalopathy as well as AIDS mortality. This dissertation research assessed whether or not visit to HIV/AIDS physician impact adherence, as well as whether such factors as education status, occupation, sex, social support and race/ethnicity modify or explain the relationship between HAART adherence and visit to the HIV/AIDS physician. Materials and Methods: A pre-existing data on HIV/AIDS HAART intervention study was used to conduct a cross-sectional study in assessing the relationship between HAART adherence and visit to HIV/AIDS physician. There were 393 total adult participants, diagnosed with HIV/AIDS and on HAART. The variables to be assessed were HAART adherence as response variable, visit to HIV/AIDS physician as the main explanatory variable, as well as other explanatory variables (education status, sex, occupational status, social support, race/ethnicity). Significance: HIV remains epidemic in some subsets of the US population, rendering this medical problem as one of the public health challenges. The mortality associated with AIDS also remains a challenge as reflected in the Healthy People 2020 which requires a reduction by 10%. The purpose of this study was to gain understanding of factors associated with adherence, thus providing the window for intervention in increasing adherence to HAART and consequently reducing the mortality related with HIV/AIDS in the US population. Results: Results of this study indicated the characterization of participants with HIV/AIDS who utilized care from a public clinic; and has shown that these individuals tend to be unemployed, have low educational attainment level, as well as, being predominantly African Americans/Blacks. Consequently, knowledge of the characteristic features of this sample may enhance how we approach the treatment and management of these individuals within our setting. When rating adherence within a four-week period, 71.5% reported good adherence and 28.5% reported poor adherence. Significant associations were found with alcohol and cocaine. Those who never drank alcohol compared to those who drank were insignificantly 9% more likely to adhere to HAART. Cocaine users were less likely to adhere to HAART compared to non-users. In contrast, there were no significant associations between adherence to HAART and race, sexual orientation and employment. Finally, results have also shown that patients who maintain regular visits with their physician were more likely to comply with HAART regimen or treatment.
Garrison, Orsolya Monika, "Impact of physician appointment on HAART adherence among HIV/AIDS population in a public clinic for HIV/AIDS, in Houston, Texas; a cross-sectional design using logistic regression modeling" (2013). Texas Medical Center Dissertations (via ProQuest). AAI3605497.