AIDS and Behavior

, Volume 19, Issue 11, pp 2117–2122

Informal Caregiver Characteristics Associated with Viral Load Suppression Among Current or Former Injection Drug Users Living with HIV/AIDS

  • Mary M. Mitchell
  • Allysha C. Robinson
  • Trang Q. Nguyen
  • Amy R. Knowlton
Original Paper

Abstract

Few studies have examined the association between having an informal (unpaid) caregiver and viral suppression among persons living with HIV/AIDS (PLHIV) who are on antiretroviral therapy. The current study examined relationships between caregivers’ individual and social network characteristics and care recipient viral suppression. Baseline data were from the BEACON study caregivers and their HIV seropositive former or current drug using care recipients, of whom 89 % were African American (N = 258 dyads). Using adjusted logistic regression, care recipient’s undetectable viral load was positively associated with caregiver’s limited physical functioning and negatively associated with caregivers having few family members to turn to for problem solving, a greater number of current drug users in their network, and poorer perceptions of the care recipient’s mental health. Results further understandings of interpersonal relationship factors important to PLHIV’s health outcomes, and the need for caregiving relationship-focused intervention to promote viral suppression among PLHIV.

Keywords

HIV/AIDS Viral load and suppression Care recipients Informal caregivers Social networks 

References

  1. 1.
    Fisher M, Cooper V. HIV and ageing: premature ageing or premature conclusions? Curr Opin Infect Dis. 2012;25(1):1–3.Google Scholar
  2. 2.
    Wolf MS, Davis TC, Osborn CY, et al. Literacy, self-efficacy, and HIV medication adherence. Patient Educ Couns. 2007;65(2):253–60.CrossRefPubMedGoogle Scholar
  3. 3.
    Mannheimer S, Friedland G, Matts J, Child C, Chesney M. The consistency of adherence to antiretroviral therapy predicts biologic outcomes for human immunodeficiency virus-infected persons in clinical trials. Clin Infect Dis. 2002;34(8):1115–21.CrossRefPubMedGoogle Scholar
  4. 4.
    Wood E, Hogg RS, Lima VD, et al. Highly active antiretroviral therapy and survival in HIV-infected injection drug users. JAMA. 2008;300:550–4.Google Scholar
  5. 5.
    Tucker JS, Burnam MA, Sherbourne CD, Kung FY, Gifford AL. Substance use and mental health correlates of nonadherence to antiretroviral medications in a sample of patients with human immunodeficiency virus infection. Am J Med. 2003;573–80.Google Scholar
  6. 6.
    Kimberlin C, Brushwood D, Allen W, Radson E, Wilson D. Cancer patient and caregiver experiences: communication and pain management issues. J Pain Symptom Manage. 2004;28(6):566–78.CrossRefPubMedGoogle Scholar
  7. 7.
    Knowlton AR, Curry A, Hua W, Wissow L. Depression and social context: primary supporter relationship factors associated with depressive symptoms among a disadvantaged population with HIV/AIDS. J Community Psychol. 2009;526–41.Google Scholar
  8. 8.
    Rodakowski J, Skidmore ER, Rogers JC, et al. Role of social support in predicting caregiver burden. Arch Phys Med Rehabil. 2012;93:2229–36.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Bass DM, Judge KS, Snow AL, et al. Negative caregiving effects among caregivers of veterans with dementia. Am J Geriatr Psychiatry. 2012;20(3):239–47.CrossRefPubMedGoogle Scholar
  10. 10.
    Knowlton AR, Latkin CA. Network financial support and conflict as predictors of depressive symptoms among a highly disadvantaged population. J Community Psychol. 2007;35(1):13–28.CrossRefGoogle Scholar
  11. 11.
    Edwards LV. Perceived social support and HIV/AIDS medication adherence among African American women. Qual Health Res. 2006;16:679–91.CrossRefPubMedGoogle Scholar
  12. 12.
    Beals KP, Wight RG, Aneshensel CS, Murphy DA, Miller-Martinez D. The role of family caregivers in HIV medication adherence. AIDS Care. 2006;18(6):589–96.CrossRefPubMedGoogle Scholar
  13. 13.
    Knowlton AR, Arnsten JH, Gourevitch MN, Eldred L, Wilkinson JD, Rose CD, Buchanan A, Purcell DW. Microsocial environmental influences on highly active antiretroviral therapy outcomes among active injection drug users. J Acquir Immune Defic Syndr. 2007;46(2):S110–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Knowlton AR, Yang C, Bohnert A, et al. Informal care and reciprocity of support are associated with HAART adherence among men in Baltimore, MD, USA. AIDS Behav. 2011;15:1429–36.PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Bachner YG, Carmel S. Open communication between caregivers and terminally ill cancer patients: the role of caregivers’ characteristics and situational variables. Health Commun. 2009;24(6):524–31.CrossRefPubMedGoogle Scholar
  16. 16.
    Wittenberg-Lyles E, Demiris G, Oliver DP, Burt S. Reciprocal suffering: caregiver concerns during hospice care. J Pain Symp Manage. 2011;41(2):383–93.CrossRefGoogle Scholar
  17. 17.
    Talley RC, Crews JE. Framing the public health of caregiving. Am J Public Health. 2007;97(2):224–8.PubMedCentralCrossRefPubMedGoogle Scholar
  18. 18.
    Arribas JR, Horban A, Gerstoft J, et al. The MONET trial: darunavir/ritonavir with or without nucleoside analogues, for patients with HIV RNA below 50 copies/ml. AIDS. 2010;(2):223–30.Google Scholar
  19. 19.
    Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living activities of daily living. Gerontologist. 1969;9:179–86.Google Scholar
  20. 20.
    Radloff LS. CES-D scale: a self-report depression scale for research in the general populations. Appl Psych Meas. 1977;1:385–401.CrossRefGoogle Scholar
  21. 21.
    IBM Corporation. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corporation; 1999.Google Scholar
  22. 22.
    Stetz KM, Brown MA. Physical and psychosocial health in family caregiving: a comparison of AIDS and cancer caregivers. Public Health Nurs. 2004;21:533–40.CrossRefPubMedGoogle Scholar
  23. 23.
    Dyer TP, Stein JA, Rice E, Rotheram-Borus MJ. Predicting depression in mothers with and without HIV: the role of social support and family dynamics. AIDS Behav. 2012;16(8):2198–208.PubMedCentralCrossRefPubMedGoogle Scholar
  24. 24.
    Mosack KE, Petroll A. Patients’ perspectives on informal caregiver involvement in HIV health care appointments. AIDS Patient Care STDS. 2009;23(12):1043–51.PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Mitchell MM, Robinson AC, Wolff JL, Knowlton AR. Perceived mental health status of injection drug users living with HIV/AIDS: concordance between informal HIV caregivers and care recipient self-reports and associations with caregiving burden and reciprocity. AIDS Behav. 2014;18(1):1103–13.PubMedCentralCrossRefPubMedGoogle Scholar
  26. 26.
    Carrico AW, Bangsberg DR, Weiser SD, et al. Psychiatric correlates of HAART utilization and viral load among HIV-positive impoverished persons. AIDS. 2011;25(8):1113–8.PubMedCentralCrossRefPubMedGoogle Scholar
  27. 27.
    Gonzalez JS, Batchelder AW, Psaros C, Safren SA. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acq Immu Def Synd. 2011;58(2):181–7.Google Scholar
  28. 28.
    Mehta S, Moore RD, Graham NM. Potential factors affecting adherence with HIV therapy. AIDS. 1997;11(14):1665–70.Google Scholar
  29. 29.
    Kaaya S, Eustache E, Lapidos-Salaiz I, et al. Grand challenges: improving HIV treatment outcomes by integrating interventions for co-morbid mental illness. PLoS Med. 2013;10(5):e1001447.PubMedCentralCrossRefPubMedGoogle Scholar
  30. 30.
    Reich WA, Lounsbury DW, Zaid-Muhammad S, Rapkin BD. Forms of social support and their relationships to mental health in HIV-positive persons. Psychol Health Med. 2010;15(2):135–45.CrossRefPubMedGoogle Scholar
  31. 31.
    Pearlin LI, Mullan JT, Semple SJ, Skaff MM. Caregiving and the stress process: an overview of concepts and their measures. Gerontologist. 1990;30(5):583–94.CrossRefPubMedGoogle Scholar
  32. 32.
    Gross R, Bellamy SL, Chapman J, et al. Managed problem solving for antiretroviral therapy adherence. JAMA Intern Med. 2013;173(4):300–6.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Mary M. Mitchell
    • 1
  • Allysha C. Robinson
    • 1
  • Trang Q. Nguyen
    • 1
  • Amy R. Knowlton
    • 1
  1. 1.Department of Health, Behavior, and SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA

Personalised recommendations