Medication nonadherence during COVID-19 among Miami-Dade Ryan White Program clients
Conference
Ward, MK, Sheehan, DM, Li, T et al. (2022). Medication nonadherence during COVID-19 among Miami-Dade Ryan White Program clients
. ANNALS OF EPIDEMIOLOGY, 67 124. 10.1016/j.annepidem.2021.07.022
Ward, MK, Sheehan, DM, Li, T et al. (2022). Medication nonadherence during COVID-19 among Miami-Dade Ryan White Program clients
. ANNALS OF EPIDEMIOLOGY, 67 124. 10.1016/j.annepidem.2021.07.022
Purpose: We examined factors associated with antiretroviral therapy (ART) nonadherence during the COVID-19 Pandemic among Miami-Dade County Ryan White Program (RWP) enrollees. Methods: A cross-sectional telephone survey of 298 RWP clients was conducted between October 2020 and January 2021. Nonadherence was defined as missing one or more doses of HIV medication during the previous four days. Crude and adjusted associations with nonadherence were estimated using logistic regression. Results: The sample was 43.3% Hispanic, 38.9% Black/African American, and 17.8% Haitian. Overall, 14.6% reported ART nonadherence. The final adjusted model included factors significantly associated with nonadherence in crude models (access to an HIV doctor and difficulty paying for housing compared with before the Pandemic, age, and federal poverty level [FPL]) as well gender, race/ethnicity, and nativity. RWP clients reporting greater difficulty accessing an HIV doctor compared with before the Pandemic had higher odds of nonadherence (adjusted odds ratio [aOR] = 3.63, 95% confidence interval [CI]: 1.64-8.01) in reference to those reporting no change or easier access. 35-44 year olds had higher odds of nonadherence (aOR = 3.03, 95% CI: 1.16-7.91) compared with RWP clients 55 or older. Odds of nonadherence were lower among individuals with household incomes 100-199% FPL (aOR = 0.19; 95% CI: 0.07-0.54) compared to 20 0-30 0% FPL. Gender, race/ethnicity, nativity, and difficulty paying for housing were not significant in the adjusted model. Conclusion: In this diverse sample of RWP clients, difficulty accessing an HIV doctor was strongly associated with ART nonadherence. Our findings underscore the importance of maintaining accessible HIV care during a public health crisis. Acknowledgements: This research was supported by the National Institute on Minority Health & Health Disparities (NIMHD) under Award Number R01MD012421-02S1, and partially supported by Award Number K01MD013770. The authors also gratefully acknowledge the use of the services and facilities supported in part by NIMHD under Award Number U54MD012393, Florida International University Research Center in Minority Institutions. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
