Dissertation (Masters) Association between Stress and Antiretroviral Therapy Adherence among Women Living with HIV in Toronto, Ontario: Assessment of Correlates, Mediation and Moderation

Author

Anita Charline Benoit

Abstract

This cross-sectional study sought to: ”Determine the association between stress, depression and ART adherence among women living with and accessing care for HIV in Toronto, Ontario, between 2007 and 2012h. Using OCS data, logistic regression models were used to identify covariates of (≥95%) adequate adherence and mediators and moderators in the association between stress and adherence. Among 307 women, 34.5% and 65.5% had poor and adequate adherence, respectively. Women with poor versus adequate adherence had more reports of hazardous alcohol use, stress events and depressive symptoms. No hazardous alcohol use (aOR=2.20, 95%CI:1.12- 4.32) and fewer stress events (aOR=0.56, 95%CI:0.33-0.94) were associated with increased odds of adequate adherence. The association between environmental stress and adequate adherence was attenuated among women ≤35 years (aOR=0.73, 95%CI:0.56-0.94) versus ≥45 years (aOR=0.51, 95%CI:0.34-0.77). Interventions to improve adherence and ensure levels ≥95% must address stress and promote adaptive coping strategies to reduce or eliminate hazardous alcohol use.


Supervisor

Mona Loutfy


Committee

Kelly O'Brien