Do syndemic conditions predict HIV medication adherence among urban African American men?
Scott Edward RutledgeJingwen ZhangLarry D IcardJohn B JemmottPublished in: AIDS care (2024)
Much progress has been made in advancing antiretroviral (ART) adherence, yet disparities remain. To explore relationships of syndemic conditions - co-occurring health conditions caused by combinations of biological, social, and structural factors - to ART adherence among African American men, we used data from longitudinal assessments of 302 African American men enrolled in a study designed to increase physical activity and healthy eating. Syndemic conditions included alcohol dependency, drug dependency, depression, post-traumatic stress disorder, and unstable housing. A syndemic conditions variable was operationalized to indicate the presence of 0-5 conditions. About 55% of participants had 1 or more syndemic conditions. Age and marriage were positively associated with ART adherence, whereas number of syndemic conditions was negatively associated with adherence during the 12-month period. The interaction of being married and the syndemic conditions variable significantly predicted greater adherence. Similarly, the interaction of more education and the syndemic conditions variable predicted greater adherence. In multiple regression models, the syndemic conditions variable remained significant (-0.018) in predicting adherence; however, there was no significant interaction among the 5 conditions. This study lends evidence to syndemics literature indicating deleterious consequences of negative life experiences on health outcomes.
Keyphrases
- african american
- physical activity
- healthcare
- hiv infected
- mental health
- antiretroviral therapy
- emergency department
- systematic review
- hiv positive
- metabolic syndrome
- body mass index
- type diabetes
- public health
- hiv aids
- glycemic control
- risk assessment
- skeletal muscle
- south africa
- climate change
- weight loss
- cross sectional
- quality improvement
- social support