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. 2024 Mar 1;95(3):215-221.
doi: 10.1097/QAI.0000000000003345.

Factors Associated With Antiretroviral Adherence Among Youth Living With HIV

Elizabeth Mayfield Arnold  1 , Susan Kamal  2 , Mary Jane Rotheram-Borus  2 , S Kate Bridges  1 , William Gertsch  2 , Peter Norwood  2 , Dallas Swendeman  2 ; Adolescent Medicine Trials Network (ATN) CARES Team
Affiliations

Factors Associated With Antiretroviral Adherence Among Youth Living With HIV

Elizabeth Mayfield Arnold et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Youth living with HIV (YLH) have an increased risk for psychosocial stressors that can affect their antiretroviral (ARV) adherence. We examined factors associated with self-reported ARV adherence among YLH ages 12-24 years old.

Setting: YLH (N = 147) were recruited in Los Angeles, CA, and New Orleans, LA from 2017 to 2020.

Methods: YLH whose self-reported recent (30 days) ARV adherence was "excellent" or "very good" were compared with nonadherent YLH on sociodemographic, clinical, and psychosocial factors using univariate and multivariate analyses.

Results: Participants were predominantly male (88%), and 81% identified as gay, bisexual, transgender, queer, or other. The mean duration on ARV was 27 months (range 0-237 months). Most YLH (71.2%) self-reported being adherent, and 79% of those who self-reported adherence were also virally suppressed (<200 copies/mL). Multivariate analysis indicated being adherent was significantly associated with white race [aOR = 8.07, confidence intervals (CI): 1.45 to 74.0], Hispanic/Latinx ethnicity [aOR = 3.57, CI: 1.16 to 12.80], more social support [aOR = 1.11, CI: 1.05 to 1.18], and being on ARV for a shorter duration [aOR = 0.99, CI: 0.97 to 0.99]. Mental health symptoms, substance use, age, and history of homelessness or incarceration were unrelated to adherence.

Conclusions: Enhancing efforts to provide support for adherence to non-white youth, and those with limited social support and who have been on ARV treatment longer, may help increase viral suppression among YLH.

Trial registration: ClinicalTrials.gov NCT03109431.

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Conflict of interest statement

E.M.A. was a consultant on a project funded by Merck, Sharpe, and Dohme and has current funding from this entity, but this relationship is not related to the current study. The other authors have declared that they have no competing or potential conflicts of interest. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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