Factors Associated with Antiretroviral Adherence among Youth Living with HIV

Abstract

Background: Youth living with HIV (YLH) have an increased risk for psychosocial stressors that can impact their antiretroviral (ARV) adherence. We examined factors associated with self-reported ARV adherence among YLH ages 12-24 years old. Setting: YLH (N=147) were recruited in Los Angeles, California, and New Orleans, Louisiana from 2017-2020. Methods: YLH whose self-reported recent (30 days) ARV adherence was “excellent” or “very good” were compared to non-adherent YLH on sociodemographic, clinical, and psychosocial factors using both univariate and multivariate analyses. Results: Participants were predominantly male (88%), and 81% identified as gay, bisexual, transgender, queer, or other. The mean duration on ARV was 27 months (range: 0-237 months). Most YLH (71.2%) self-reported being adherent, and 79% of those who self-reported adherence were also virally suppressed (<200 copies/mL). Multivariate analysis indicated being adherent was significantly associated with white race [aOR=8.07, (CI=1.45, 74.0)], Hispanic/Latinx ethnicity [aOR=3.57, CI=(1.16, 12.80)], more social support [aOR=1.11, (CI=1.05, 1.18)], and being on ARV for a shorter duration [aOR=0.99, (CI=0.97, 0.99)]. Mental health symptoms, substance use, age, and history of homelessness or incarceration were unrelated to adherence. Conclusions: Enhancing efforts to provide support for adherence to non-white youth, as well as those with limited social support and who have been on ARV treatment longer, may help increase viral suppression among YHL.