Trauma, dissociation, and antiretroviral adherence among persons living with HIV/AIDS

• Published in: Journal of psychiatric research 2011-07, Vol.45 (7), p.942-948
• Main Authors: Keuroghlian, Alex S, Kamen, Charles S, Neri, Eric, Lee, Susanne, Liu, Rhianon, Gore-Felton, Cheryl
• Format: Article
• Language: English
• Subjects: Acquired Immunodeficiency Syndrome - drug therapy; Acquired Immunodeficiency Syndrome - psychology; Adherence; Adult; Adult and adolescent clinical studies; Anti-HIV Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral therapy; Antiviral agents; Anxiety disorders. Neuroses; Biological and medical sciences; Cross-Sectional Studies; Depression; Dissociation; Dissociative Disorders - diagnosis; Dissociative Disorders - psychology; Drug Administration Schedule; HIV; HIV Infections - drug therapy; HIV Infections - psychology; HIV/AIDS; Human viral diseases; Humans; Infectious diseases; Life Change Events; Male; Medical sciences; Medication; Medication Adherence - psychology; Middle Aged; Mood disorders; Pharmacology. Drug treatments; Post-traumatic stress disorder; Posttraumatic stress disorder; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - psychology; Symptoms; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2011.05.003

Abstract Background There are approximately 1,000,000 persons living with HIV/AIDS (PLH) in the United States; to reduce rates of new infection and curb disease progression, adherence to HIV medication among PLH is critical. Despite elevated trauma rates in PLH, no studies to date have investigated the relationship between dissociation, a specific symptom of trauma, and HIV medication adherence. We hypothesized that Post-Traumatic Stress Disorder (PTSD) symptoms would be associated with lower adherence, and that dissociation would moderate this relationship. Methods Forty-three individuals with HIV were recruited from community-based clinics to participate in a cross-sectional study. The relationship of trauma, dissociation, and their interaction to the probability of antiretroviral adherence was assessed using a hierarchical binary logistic regression analysis. Results Among 38 eligible participants, greater PTSD was associated with lower odds of adherence (OR = .92, p