Research and Publications - Department of Health Science

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Browsing Research and Publications - Department of Health Science by Author "Adimora, Adaora A."

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    Healthcare Empowerment and HIV Viral Control: Mediating Roles of Adherence and Retention in Care
    (Elsevier, 2018) Wilson, Tracey E.; Kay, Emma Sophia; Turan, Bulent; Johnson, Mallory O.; Kempf, Mirjam-Colette; Turan, Janet M.; Cohen, Mardge H.; Adimora, Adaora A.; Pereyra, Margaret; Golub, Elizabeth T.; Goparaju, Lakshmi; Murchison, Lynn; Wingood, Gina M.; Metsch, Lisa R.; State University of New York (SUNY) Downstate Medical Center; University of Alabama Tuscaloosa; University of Alabama Birmingham; University of California San Francisco; University of North Carolina School of Medicine; University of North Carolina; University of North Carolina Chapel Hill; Columbia University; Johns Hopkins University; Johns Hopkins Bloomberg School of Public Health; Georgetown University; Montefiore Medical Center; Yeshiva University; Albert Einstein College of Medicine
    Introduction: This study assessed longitudinal relationships between patient healthcare empowerment, engagement in care, and viral control in the Women's Interagency HIV Study, a prospective cohort study of U.S. women living with HIV. Methods: From April 2014 to March 2016, four consecutive 6-month visits were analyzed among 973 women to assess the impact of Time 1 healthcare empowerment variables (Tolerance for Uncertainty and the state of Informed Collaboration Committed Engagement) on Time 2 reports of >= 95% HIV medication adherence and not missing an HIV primary care appointment since last visit; and on HIV RNA viral control across Times 3 and 4, controlling for illicit drug use, heavy drinking, depression symptoms, age, and income. Data were analyzed in 2017. Results: Adherence of >= 95% was reported by 83% of women, 90% reported not missing an appointment since the last study visit, and 80% were categorized as having viral control. Logistic regression analyses revealed a significant association between the Informed Collaboration Committed Engagement subscale and viral control, controlling for model covariates (AOR = 1.08, p = 0.04), but not for the Tolerance for Uncertainty subscale and viral control (AOR = 0.99, p = 0.68). In separate mediation analyses, the indirect effect of Informed Collaboration Committed Engagement on viral control through adherence (beta = 0.04, SE = 0.02, 95% CI = 0.02, 0.08), and the indirect effect of Informed Collaboration Committed Engagement on viral control through retention (beta = 0.01, SE = 0.008, 95% CI = 0.001, 0.030) were significant. Mediation analyses with Tolerance for Uncertainty as the predictor did not yield significant indirect effects. Conclusions: The Informed Collaboration Committed Engagement healthcare empowerment component is a promising pathway through which to promote engagement in care among women living with HIV. (C) 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.