Coping strategies associated with art adherence among older adults living with HIV, South Carolina.

Abstract

People living with HIV/AIDS (PLWH) are living longer due to improvements in HIV care including antiretroviral therapy (ART). Even though ART improves HIV prognosis and life expectancy, its adherence is hindered by many factors. As the population of older adults living with HIV (OALH) continues to increase, it is important to understand the psychosocial factors that are associated with living with HIV to improve ART adherence. The aim of this study was to determine the association between coping strategies and ART adherence. Data were obtained from 91 OALH at an immunology clinic in Columbia, South Carolina via purposive sampling. The participants were at least 50 years or older and living with HIV. Coping was assessed using the Brief COPE Inventory. Crude and adjusted linear regression models, controlling for age, race, gender, and were used to determine the association between coping strategies and ART adherence. Subgroup analyses were done to determine if the association between coping and ART adherence varied by gender. The analyses were conducted in SAS version 9.4. The mean difference in ART adherence was statistically significant for race (p = 0.0292). There was a statistically significant association between religion and ART adherence (β = -0.718, p = 0.024). Males who use venting as a coping mechanism had higher ART adherence (β = 1.227, p = 0.048), and males who use behavioral disengagement had lower ART adherence (β = -1.624, p = 0.003) after adjusting for age and race. OALH who use religion as a coping strategy were less likely to adhere to ART treatment. Venting and behavioral disengagement tend to be associated with ART adherence among men. Qualitative research is needed to delve deeper into the relationship between religious coping and ART adherence, especially among OALH.