Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep;24(9):2656-2665.
doi: 10.1007/s10461-020-02823-3.

Factors Related to Biological Sex Differences in Engagement with Healthcare Providers in Persons Living with HIV

Dawon Baik  1 , Jianfang Liu  2 , Hwayoung Cho  3 , Rebecca Schnall  2
Affiliations

Factors Related to Biological Sex Differences in Engagement with Healthcare Providers in Persons Living with HIV

Dawon Baik et al. AIDS Behav. 2020 Sep.

Abstract
in English, Spanish

Little is known about how engagement with healthcare providers mediates the relationship between psychosocial factors (anxiety, depression, stigma) and medication adherence among persons living with HIV (PLWH). Moreover, little research has investigated potential biological sex differences in this relationship. We conducted a secondary analysis of data collected from four projects (N = 281) focused on improving health outcomes in PLWH. Males displayed (a) negative association between depression and engagement with healthcare providers (β = - 0.02, z = - 3.20, p = 0.001) and (b) positive association between engagement with healthcare providers and medication adherence (β = 0.55, OR = 1.73, z = 2.62, p = 0.009). Females showed no association between any of these factors. Anxiety and stigma were not significantly associated with medication adherence. Path analysis modeling for males had a very good fit (CFI = 1, TLI = 1, RMSEA = 0); none of the regression coefficients was significant for females. The significant relationship between depression and medication adherence among males was fully mediated by engagement with healthcare providers. Findings suggest that adherence interventions for PLWH should be tailored by biological sex.

Poco se sabe cómo la interacción con proveedores médicos funciona en la relación entre factores psicosociales (ansiedad, depresión, estigma) y adherencia a medicamentos en personas viviendo con VIH (PVV). Además, pocos estudios han inves- tigado posibles diferencias en el sexo biológico en estas relacione. Dirigimos un análisis secundario de cuatro proyectos (N = 281) enfocados en PVV. Hombres demostraron (a) una asociación negativa entre depresión e interacción con proveedores médicos (β=−0.02, z=−3.20, p= 0.001) y (b) una asociación positive entre interacción con proveedores médicos y adherencia a medicamentos (β= 0.55, OR= 1.73, z= 2.62, p= 0.009). Mujeres no demostraron asociación entre estos factores. Ansiedad y estigma no fueron asociados significativamente con la adherencia a medicamentos. El modelo de análisis del camino para hombres tuvo un muy ajuste (CFI = 1, TLI = 1, RMSEA = 0); ninguna de los coeficientes de regresión fue significativa para mujeres. La relación significativa entre depresión y adherencia a medicamentos para hombres fue completamente mediada por la interacción con proveedores médicos. Las recomendaciones sugieren que las intervenciones de adherencia para PVV deberían ser ajustado por sexo biológico.

Keywords: Depression; HIV/AIDS; Medication adherence; Patient–provider engagement; Sex differences.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Proposed conceptual model
Fig. 2
Fig. 2
Path analysis model for males
Fig. 3
Fig. 3
Path analysis model for females
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Heestermans T, Browne JL, Aitken SC, Vervoort SC, Klipstein-Grobusch K. Determinants of adherence to antiretroviral therapy among HIV-positive adults in sub-Saharan Africa: a systematic review. BMJ Glob Health. 2016;1(4):e000125. - PMC - PubMed
    1. Selik RM, Lindegren ML. Changes in deaths reported with human immunodeficiency virus infection among United States children less than thirteen years old, 1987 through 1999. Pediatr Infect Dis J. 2003;22(7):635–41. - PubMed
    1. Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;382(9903):1525–33. - PMC - PubMed
    1. Centers for Disease Control and Prevention. More people with HIV have the virus under control. 2017. https://www.cdc.gov/nchhstp/newsroom/2017/2017-HIV-Continuum-Press-Relea.... Accessed 27 July 2017
    1. Langebeek N, Gisolf EH, Reiss P, Vervoort SC, Hafsteinsdottir TB, Richter C, et al. Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: a meta-analysis. BMC Med. 2014;12:142. - PMC - PubMed