High Distress in Black MSM Lowers Odds of Antiretroviral Therapy Adherence

Increased psychological distress was significantly linked with nonadherence to antiretroviral therapy among Black gay and bisexual men (MSM) with human immunodeficiency virus (HIV) in urban areas, according to study findings published in the International Journal of STD & AIDS.

Distress, advised researchers from Johns Hopkins University, “may represent an important barrier to viral suppression.”

To gauge the association between psychological distress and antiretroviral therapy as well as pre-exposure prophylaxis (PrEP) adherence, the study tapped data from a 4-year prospective cohort study of 165 Black MSM. For antiretroviral therapy, adherence was defined as more than 95% of doses taken in the past 30 days. For PrEP, adherence constituted more than 80% of doses taken in the past 30 days.

Some 44.2% of men in the study reported high psychological distress.

Among men who were HIV negative, 39.8% were adherent to PrEP, according to the study. Education was significantly linked with PrEP adherence in the population.

Meanwhile, 65.3% of men with HIV were adherent to antiretroviral therapy. Noninjection drug use in the past 3 months, difficulty sleeping, feeling anxious, feeling sad or depressed, and overall psychological distress were significantly associated with antiretroviral therapy adherence, researchers reported.

“High psychological distress was significantly associated with a reduced odds of antiretroviral adherence adherence (aOR 0.23; 95% CI = 0.08-0.70),” researchers wrote, “adjusting for age and noninjection drug use.”

Reference:
Jimenez V, Thornton N, Tilchin C, et al. Psychological distress and adherence to anti-retroviral therapy or pre-exposure prophylaxis regimens among Urban Black gay and bisexual men (MSM). Int J STD AIDS. Published online August 26, 2022. doi:10.1177/09564624221123466