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Daily Predictors of ART Adherence Among Young Men Living with HIV Who Have Sex with Men: A Longitudinal Daily Diary Study

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Abstract

Improving adherence to antiretroviral therapy (ART) is essential for limiting HIV disease progression among young sexual minority men living with HIV. Daily diaries allow for a detailed examination of how fluctuations in psychosocial factors are associated with adherence over time. Across three cities in the United States, this study collected 60 days of quantitative data from 44 young men (between 16 and 24 years of age) living with HIV who have sex with men. Lagged transition models explored the associations of mood, stress, social support, substance use, and condomless intercourse with daily ART adherence. Baseline levels of illicit substance use and condomless intercourse, and a higher proportion of days with stress or marijuana use, were associated with lower ART adherence. Lapses in adherence predicted non-adherence the following day. Findings suggest prospective data collection may identify different predictors of adherence compared to retrospective recall. Lapse-management strategies are needed to improve adherence following a missed dose.

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Data Availability

Data are available through NICHD DASH via an approved data use agreement.

Code Availability

The SAS code to conduct the statistical analyses presented in this paper is available by request to the authors.

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Acknowledgements

We acknowledge NICHD DASH for providing the data that was used for this research. We thank the Adolescent Medicine Trials Network for HIV/AIDS Interventions, ATN 112 protocol team HIV clinic sites, and all of the clinic staff involved in this study, including Dr. Craig Wilson, ATN Principal Investigator; Dr. Patrick A. Wilson, ATN 112 Protocol Chair; The Adolescent Medicine Trials Network for HIV /AIDS Interventions (ATN), with NIH support through NICHD (Kapogiannis, B and Lee, S), with supplemental funding from NIDA (Davenny, K) and NIMH (Allison, S): U01 HD 40533 and U01 HD 40474. We extend our sincerest gratitude to each participant for their effort and willingness to take part in this research.

Funding

This work was supported by the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) from the National Institutes of Health (U24HD089880) through the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute on Minority Health and Health Disparities (NIMHD), National Institute of Mental Health (NIMH), and National Institute on Drug Abuse (NIDA). 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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  1. Emily M. Cherenack

    Present address: University of Miami, Clinical Research Building, 1120 NW 14th Street, Miami, FL, 33136, USA

Authors and Affiliations

  1. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA

    Emily M. Cherenack

  2. Department of Psychology and Neuroscience, Duke University, Durham, NC, USA

    Emily M. Cherenack

  3. Department of Biostatistics, Collaborative Studies Coordinating Center, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Kimberly Enders, Betty M. Rupp & Matthew Psioda

  4. Institute for Global Health and Infectious Diseases, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Arlene C. Seña

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Contributions

EC contributed to study design with the support of the ATN 112 protocol team. Data preparation and analysis was performed by KE and MP. The first draft of the manuscript was written by EC and KE. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Emily M. Cherenack.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

Ethical approval for research involving human participants was obtained from Institutional Review Boards (IRBs) at all participating institutions, including Columbia University Medical Center, University of North Carolina at Chapel Hill, Children’s Hospital of Philadelphia, Children’s Hospital of Michigan, and the University of Colorado School of Medicine Children’s Hospital. A federal Certificate of Confidentiality was obtained. This study was performed in accordance the 1964 Declaration of Helsinki and its later amendments.

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

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Cherenack, E.M., Enders, K., Rupp, B.M. et al. Daily Predictors of ART Adherence Among Young Men Living with HIV Who Have Sex with Men: A Longitudinal Daily Diary Study. AIDS Behav 26, 1727–1738 (2022). https://doi.org/10.1007/s10461-021-03523-2

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