|
1
|
Ward MK, Aleite S, Sheehan DM, Li T, Gbadamosi SO, Jean-Gilles M, Ladner RA, Trepka MJ. Self-reported Nonadherence to Antiretroviral Therapy Among Miami-Dade Ryan White Program Clients During the COVID-19 Pandemic: A Cross-sectional Study. J Assoc Nurses AIDS Care 2023; 34:198-206. [PMID: 36607312 PMCID: PMC10062022 DOI: 10.1097/jnc.0000000000000382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Indexed: 01/07/2023]
Abstract
This study examined factors associated with self-reported ART nonadherence during the COVID-19 pandemic among Miami-Dade County Ryan White HIV/AIDS Program (RWHAP) clients. A cross-sectional survey was conducted from October 2020-January 2021 in English, Spanish, and Haitian Creole. The survey included questions on self-reported ART adherence, HIV care access (compared to before the pandemic), social and economic pandemic impacts, and demographics. We carried out descriptive bivariate analyses and weighted logistic regression to estimate unadjusted and adjusted odds ratios (aORs) for self-reported nonadherence. 12.7% of participants reported ART nonadherence. Adjusting for age, sex, race/ethnicity, and nativity, factors associated with nonadherence included greater difficulty accessing an HIV doctor compared with before the COVID-19 pandemic (aOR=3.6, 95% CI: 1.4–9.2) and experiencing financial impacts due to the pandemic (aOR=4.2, 95% CI: 1.5–12.2). Ensuring RWHAP clients maintain access to HIV medical care providers and receive support for financial shocks are critical to sustaining ART adherence.
Collapse
Affiliation(s)
- Melissa K Ward
- Melissa K. Ward, PhD, MPH, is an Assistant Professor, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, and Research Center in Minority Institutions, Florida International University, Miami, Florida, USA. Stephanie Aleite, BA, is an MSW Student, School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA. Diana M. Sheehan, PhD, MPH, is an Assistant Professor, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Research Center in Minority Institutions, and Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, Florida, USA. Tan Li, PhD, is an Associate Professor, Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA. Semiu O. Gbadamosi, PhD, MBBS, MPH, was a PhD Candidate, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA. Michèle Jean-Gilles, PhD, is a Research Associate Professor, Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA. Robert A. Ladner, PhD, is President, Behavioral Science Research Corporation, Miami, Florida, USA. Mary Jo Trepka, MD, MSPH, is a Professor, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, and Research Center in Minority Institutions, Florida International University, Miami, Florida, USA
| | | | | | | | | | | | | | | |
Collapse
|
|
2
|
Kates J. Implications of the Affordable Care Act for people with HIV infection and the Ryan White HIV/AIDS Program: what does the future hold? Top Antivir Med 2013; 21:138-42. [PMID: 24225080 PMCID: PMC6148845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
There are numerous aspects of the Patient Protection and Affordable Care Act that will be important for people in the United States with HIV infection, including consumer protections and private insurance reforms, establishment of health care marketplaces in every state, new benefit standards, Medicare fixes, prevention enhancements, expansion of Medicaid, and health system improvements. However, it is unlikely that these changes will address all the needs of people with HIV infection in the United States. The Ryan White HIV/AIDS Program will thus remain crucial for the provision of adequate health care to HIV-infected individuals, but it will need to change. Changes in the role of the Ryan White HIV/AIDS Program will depend largely on state decisions on Medicaid expansion and health care marketplaces. This article summarizes a presentation by Jennifer Kates, PhD, at the IAS-USA continuing education program held in New York, New York, in April 2013.
Collapse
|