Family Conflict Non-negotiation and HIV Disclosure Associated With ART Adherence in a Disadvantaged Population.

Adherence to antiretroviral therapy (ART) is vital for reducing racial and gender disparities in morbidity and mortality among people living with HIV/AIDS (PLWH). Little research attention has been given to aspects of family functioning affecting ART adherence among PLWH vulnerable to disparities. Data were from n = 313 participants (93% African American) in the BEACON study, which recruited injection-drug-using PLWH on ART. Using factor analysis and longitudinal structural equation modeling, we found that current substance use and negative family conflict tactics (i.e., non-negotiation) predicted PLWH's lower probability of ART adherence at 12-month follow-up; and greater HIV disclosure to support network members predicted a higher probability of adherence. These findings suggest the importance of family and other support network members in this vulnerable population's ART adherence. Social network-focused interventions promoting prosocial response to conflict and negotiation skills are important for improving vulnerable PLWH's HIV outcomes and reducing health disparities.