%0 Journal Article %J AIDS Behav %D 2014 %T Prospective predictors of unprotected anal intercourse among HIV-seropositive men who have sex with men initiating antiretroviral therapy. %A Pantalone, David W %A Huh, David %A Nelson, Kimberly M %A Pearson, Cynthia R %A Simoni, Jane M %K Adult %K Anti-HIV Agents %K Drug Administration Schedule %K Health Knowledge, Attitudes, Practice %K HIV Infections %K HIV Seropositivity %K Homosexuality, Male %K Humans %K Interviews as Topic %K Latin America %K Logistic Models %K Longitudinal Studies %K Male %K Middle Aged %K Prospective Studies %K Sexual Behavior %K Socioeconomic Factors %K Stress, Psychological %K Substance-Related Disorders %K Surveys and Questionnaires %K Unsafe Sex %K Vulnerable Populations %K Washington %K Young Adult %X

Contemporary HIV prevention efforts are increasingly focused on those already living with HIV/AIDS (i.e., "prevention with positives"). Key to these initiatives is research identifying the most risky behavioral targets. Using a longitudinal design, we examined socio-demographic and psychosocial factors that prospectively predicted unprotected anal intercourse (UAI) in a sample of 134 HIV-seropositive men who have sex with men (MSM) initiating, changing, or re-starting an antiretroviral therapy regimen as part of a behavioral intervention study. Computer-based questionnaires were given at baseline and 6 months. In a sequential logistic regression, baseline measures of UAI (step 1), socio-demographic factors such as Latino ethnicity (step 2), and psychosocial factors such as crystal methamphetamine use, greater life stress, and lower trait anxiety (step 3) were predictors of UAI at 6 months. Problem drinking was not a significant predictor. Prevention efforts among MSM living with HIV/AIDS might focus on multiple psychosocial targets, like decreasing their crystal methamphetamine use and teaching coping skills to deal with life stress.

%B AIDS Behav %V 18 %P 78-87 %8 2014 Jan %G eng %N 1 %R 10.1007/s10461-013-0477-1 %0 Journal Article %J AIDS Patient Care STDS %D 2011 %T Buffering effects of general and medication-specific social support on the association between substance use and HIV medication adherence. %A Lehavot, Keren %A Huh, David %A Walters, Karina L %A King, Kevin M %A Andrasik, Michele P %A Simoni, Jane M %K Adult %K Anti-HIV Agents %K Antiretroviral Therapy, Highly Active %K Female %K HIV Infections %K Humans %K Male %K Middle Aged %K Patient Compliance %K Social Support %K Socioeconomic Factors %K Substance-Related Disorders %K Young Adult %X

The success of highly active antiretroviral therapy (HAART) among persons living with HIV is largely dependent on strict medication adherence. Recent research suggests that alcohol and other drug use (AOD) may be an important barrier to HAART adherence. In this study, we examined the impact of AOD on HAART adherence as well as the moderating effects of general and medication-specific social support. The data were collected as part of a longitudinal randomized control trial with 224 HIV-positive patients at an HIV primary care clinic in the northwestern United States. Findings indicated that AOD use was negatively associated with HAART adherence and that medication-specific (but not general) social support moderated the AOD-adherence association at 3 (but not at 6 or 9) months. Results indicate the importance of medication-specific social support to treat comorbid AOD use and HIV; implications for future research and intervention programs for HIV-positive AOD users are discussed.

%B AIDS Patient Care STDS %V 25 %P 181-9 %8 2011 Mar %G eng %N 3 %R 10.1089/apc.2010.0314 %0 Journal Article %J AIDS Behav %D 2011 %T A preliminary randomized controlled trial of a nurse-delivered medication adherence intervention among HIV-positive outpatients initiating antiretroviral therapy in Beijing, China. %A Simoni, Jane M %A Chen, Wei-Ti %A Huh, David %A Fredriksen-Goldsen, Karen I %A Pearson, Cynthia %A Zhao, Hongxin %A Shiu, Cheng-Shi %A Wang, Xin %A Zhang, Fujie %K Adult %K Anti-HIV Agents %K CD4 Lymphocyte Count %K China %K Counseling %K Cross-Sectional Studies %K Drug Monitoring %K Electronics, Medical %K Female %K HIV Infections %K HIV-1 %K Humans %K Male %K Medication Adherence %K Middle Aged %K Nurses %K Outpatients %K RNA, Viral %K Treatment Outcome %K Viral Load %K Young Adult %X

We evaluated a nurse-delivered adherence intervention in a preliminary randomized controlled trial among 70 HIV-positive outpatients initiating antiretroviral therapy (ART) in Beijing, China. In both arms, participants received a 30-min educational session, a pillbox, and a referral to a peer support group. In the enhanced arm, participants could choose an electronic reminder device, three sessions of counseling either alone or with a treatment adherence partner, or both reminder and counseling. Survey assessments and blood draws occurred at baseline, post-intervention (13 weeks), and follow-up (25 weeks). Primary outcomes were 7-day and 30-day adherence assessed by self-report and electronic drug monitoring (EDM), and secondary outcomes were HIV-1 RNA viral load and CD4 count. The intervention was feasible and well received. It led to some improvement in self-reported and EDM-assessed adherence but not the biological outcomes. Providing counseling and facilitating the use of electronic reminders to patients initiating ART merits further investigation as a culturally viable means of promoting adherence in China.

%B AIDS Behav %V 15 %P 919-29 %8 2011 Jul %G eng %N 5 %R 10.1007/s10461-010-9828-3