Depression and treatment adherence among HIV-positive young black men who have sex with men in Atlanta, GA Open Access

Zhang, Yue (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/z029p478k?locale=en
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Abstract

Background: In the past years, HIV positive young black men who have sex with men remained low level of medical adherence in Atlanta, GA. Based on previous studies, depression was supposed to be a main harmful factor to prevent patients from medical adherence. Moreover, Social Stigma, Education, Employment and Homelessness were also important factors to associate with adherence and depression.

Objective: The purpose of this project is to examine the relationship between depression and treatment adherence among HIV-positive YBMSM in Atlanta, after controlling for Social Stigma, Education, Employment and Homelessness.

Methods: 81 HIV-positive YBMSM were recruited from adolescent clinic of a large HIV specialty clinic in Atlanta, GA between November 2015 and July 2016. After sample characteristic analysis, bivariate analysis was conducted to to evaluate crude association between Adherence and each independent variable. Then, based on Backward method, a multivariable logistic regression model was built to caculate adjust odds ratios of Depression and Adherence to evaluate their assocation after controlling other variables.

Results: The bivariable analysis showed that participants with depressive symptoms were more likely to miss medical appointments compare to those who did not have depressive symptoms (OR = 4.75, 95% CI = (1.55, 14.55)). After building multivariable logistic regression model, depression and adherence showed significant association and depression was a harmful factor for no missed appointment (OR = 4.35, 95% CI = (1.20, 15.72)), controlling for Social Stigma, Education, Employment and Homelessness. 

Conclusions: Depression was a significant harmful factor for no missed appointment, controlling for Social Stigma, Education, Employment and Homelessness, for YBMSM in Atlanta, GA. And the conclusion of this study will give a more accurate understanding of the psychological interventions for HIV-positive YBMSM, who live in Atlanta.

Table of Contents

1 Introduction      1

1.1 Background    1

1.2 Project Statement  3

1.3 Significance Statement 3

1.4 Terminology   5

2 Literature Review     6

2.1 Epidemiology of HIV among the United States, Georgia and Atlanta cases  6

2.1.1 HIV in the United States    6

2.1.2 HIV in Georgia     7

2.1.3 HIV in Atlanta     9

2.2 HIV Adherence      9

2.3 Depression and non-adherence  10

2.4 Other factors and non-adherence      11

2.4.1 Social Stigma      11

2.4.2 Education    12

2.4.3 Employment 12

2.4.4 Homelessness     13

3 Methodology    14

3.1 Population and sample 14

3.2 Measures 14

3.3 Data analysis  16

3.4 Sample Size Limitation  17

4 Results 18

4.1 Sample Characteristic   18

4.2 Bivariable analysis  20

4.3 Multivariable analysis    22

5 Discussion  23

5.1 Strengthens    23

5.2 Limitations and recommendations     24

6 Conclusion 25

7 Public Health Recommendations   26

8 Reference  27

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