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Reliability and Validity of a Brief Self-Report Adherence Measure among People with HIV Experiencing Homelessness and Mental Health or Substance Use Disorders

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Abstract

The study examines the reliability and validity of a 3-item self-report adherence measure among people with HIV (PWH) experiencing homelessness, substance use, and mental health disorders. 336 participants were included from nine sites across the US between September 2013 and February 2017. We assessed the validity of a self-report scale for adherence to antiretroviral therapy by comparing it with viral load (VL) abstracted from medical records at baseline, 6, 12, and 18 months. The items had high internal consistency (Cronbach’s alpha coefficients at each time point were > 0.8). The adherence scale scores were higher in the group that achieved VL suppression compared to the group that did not. The c-statistic for the receiver-operating characteristic curves pooled across time points was 0.77 for each adherence sub-item and 0.78 for the overall score. The self-report adherence measure shows good internal consistency and validity that correlated with VL suppression in homeless populations.

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Acknowledgements

This project was supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under Grant U90HA24974, Special Projects of National Significance Initiative “Building a Medical Home for Multiply Diagnosed HIV-Positive Homeless Populations.

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Authors and Affiliations

  1. Department of Medicine, Division of Infectious Diseases, University of Missouri, Columbia, MO, USA

    Dima Dandachi

  2. Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Dima Dandachi & Thomas P. Giordano

  3. Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA

    Alexander de Groot & Emily Quinn

  4. Department of Public Health, University of Massachusetts Lowell, Lowell, MA, USA

    Serena Rajabiun

  5. Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA

    Shruthi Rajashekara, Jessica A. Davila & Thomas P. Giordano

  6. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Shruthi Rajashekara & Jessica A. Davila

  7. Department of Biostatistics, Boston University, School of Public Health, Boston, MA, USA

    Howard J. Cabral

  8. Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA

    Ira B. Wilson

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  1. Dima Dandachi
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  2. Alexander de Groot
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  3. Serena Rajabiun
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  4. Shruthi Rajashekara
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  5. Jessica A. Davila
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  8. Ira B. Wilson
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  9. Thomas P. Giordano
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Correspondence to Dima Dandachi.

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Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Dandachi, D., de Groot, A., Rajabiun, S. et al. Reliability and Validity of a Brief Self-Report Adherence Measure among People with HIV Experiencing Homelessness and Mental Health or Substance Use Disorders. AIDS Behav 25, 322–329 (2021). https://doi.org/10.1007/s10461-020-02971-6

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  • DOI: https://doi.org/10.1007/s10461-020-02971-6

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