Abuse and Resilience in Relation to HAART Medication Adherence and HIV Viral Load Among Women with HIV in the United States
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Abuse is highly prevalent among HIV+ women, leading to behaviors, including lower adherence to highly active antiretroviral therapy (HAART) that result in poor health outcomes. Resilience (functioning competently despite adversity) may buffer the negative effects of abuse. This study investigated how resilience interacted with abuse history in relation to HAART adherence, HIV viral load (VL), and CD4+ cell count among a convenience sample of 138 HIV+ women from the Ruth M. Rothstein CORE Center/Cook County Health and Hospital Systems site of the Women's Interagency HIV Study (WIHS). Resilience was measured by the 10-item Connor-Davidson Resilience Scale (CD-RISC). HAART adherence (≥95% vs. <95% self reported usage of prescribed medication) and current or prior sexual, physical, or emotional/domestic abuse, were reported during structured interviews. HIV viral load (≥20 vs. <20 copies/mL) and CD4+ count (200 vs. <200 cells/mm) were measured with blood specimens. Multiple logistic regressions, controlling for age, race, income, enrollment wave, substance use, and depressive symptoms, indicated that each unit increase in resilience was significantly associated with an increase in the odds of having ≥95% HAART adherence and a decrease in the odds of having a detectable viral load. Resilience-Abuse interactions showed that only among HIV+ women with sexual abuse or multiple abuses did resilience significantly relate to an increase in the odds of ≥95% HAART adherence. Interventions to improve coping strategies that promote resilience among HIV+ women may be beneficial for achieving higher HAART adherence and viral suppression.
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Resilience is associated with positive health outcomes among people living with HIV, including adherence to antiretroviral therapy, viral suppression, and improved physical and mental health.
“An emerging body of evidence suggests that resilience is associated with positive health outcomes among PLWH, including adherence to ART, viral suppression (Dale et al., 2014) and improved physical and mental health (McGowan et al., 2018).”
From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Dale et al., 2014
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- Authors
- Dale, S., Cohen, M., Weber, K., Cruise, R., Kelso, G., & Brody, L.
- Affiliations
- Boston University (US)
- John H. Stroger, Jr. Hospital of Cook County (US)
- Corresponding author
- Dale, Sannisha
- Brody, Leslie
- Venue
- AIDS Patient Care and STDs
- Publisher
- SAGE Publications
- Published
- 2014-03
- Volume
- 28
- Issue
- 3
- Pages
- 136-143
- ISSN
- 1087-2914 (ISSN-L)
- 1557-7449
- PMC
- PMC3948478
- OpenAlex
- W1912907001
- Cited by
- 135
- References
- 73
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 9 · 2023: 8 · 2022: 21 · 2021: 15 · 2020: 14 · 2019: 19 · 2018: 10 · 2017: 12 · 2016: 3 · 2015: 9 · 2014: 4
- FWCI
- 6.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- AIDS Patient Care and STDs (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- U.S. Public Health Service (5U01A1034993)
- National Institute of Mental Health (F31MH095510, P30-AI082151)
- National Cancer Institute
- National Institute of Allergy and Infectious Diseases (U01AI034993, P30AI082151)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Keywords
- HIV, women living with HIV, resilience, abuse history, sexual abuse, domestic violence, HAART adherence, HIV viral load, CD4 count, coping strategies, Women's Interagency HIV Study
- MeSH terms
- Adult, Aged, Cross-Sectional Studies, Depression, Female, Humans, Middle Aged, Surveys and Questionnaires, Sex Offenses, Spouse Abuse, United States, HIV Infections, Logistic Models, Treatment Outcome, CD4 Lymphocyte Count, Viral Load, Substance-Related Disorders, Antiretroviral Therapy, Highly Active, Medication Adherence, Resilience, Psychological
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