Predictors of HIV Care Engagement, Antiretroviral Medication Adherence, and Viral Suppression Among People Living with HIV Infection in St. Petersburg, Russia

• Published in: AIDS and behavior Vol. 22; no. 3; pp. 791 - 799
• Main Authors: Amirkhanian, Yuri A., Kelly, Jeffrey A., DiFranceisco, Wayne J., Kuznetsova, Anna V., Tarima, Sergey S., Yakovlev, Alexey A., Musatov, Vladimir B.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-03-2018; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; Adhesion; AIDS; Alcohol abuse; Alcoholic beverages; Antiretroviral agents; Antiretroviral drugs; Anxiety; Drug abuse; Effectiveness; Health problems; Health Psychology; HIV; Human immunodeficiency virus; Infectious Diseases; Intravenous drugs; Medication adherence; Medicine; Medicine & Public Health; Mental health services; Original Paper; Patient compliance; Prescription drugs; Public Health; Self-efficacy; Social networks; Social organization; Substance abuse; Substance use; Well being; Russia; HIV-positive; HIV care linkage and retention; Persons living with HIV; HIV medical care; HIV services; Russia
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-016-1638-9

Over 1 million HIV infections have been diagnosed in Russia, and HIV care uptake and viral suppression are very low. 241 HIV-positive individuals in St. Petersburg were enrolled through social networks, provided blood for viral load testing, and completed measures of medication-taking adherence, readiness, and self-efficacy; psychosocial well-being; and substance use. Outcomes included attending an HIV care appointment in the past 6 months, >90% ART adherence, and undetectable viral load. 26% of participants had no recent care appointment, 18% had suboptimal adherence, and 56% had detectable viral load. Alcohol use consistently predicted all adverse health outcomes. Having no recent care visit was additionally associated with being single and greater past-month drug injection frequency. Poor adherence was additionally predicted by lower medication-taking self-efficacy and lower anxiety. Detectable viral load was additionally related to younger age. Comprehensive interventions to improve HIV care in Russia must address substance abuse, anxiety, and medication-taking self-efficacy.