Whats Love Got to Do With It? Relationship Factors and HIV - - PowerPoint PPT Presentation
Whats Love Got to Do With It? Relationship Factors and HIV Treatment Adherence Mallory O. Johnson, Ph.D. Mallory.Johnson@ucsf.edu Center for AIDS Prevention Studies University of California, San Francisco Center for Health, Intervention,
Relationship Factors and HIV Treatment Adherence
Mallory O. Johnson, Ph.D. Mallory.Johnson@ucsf.edu
Center for AIDS Prevention Studies University of California, San Francisco
Center for Health, Intervention, and Prevention Nov. 18, 2010
adherence
2000 4000 6000 8000 10000 600 1200 1800 2400 3000
80 82 84 86 88 90 92 94 96 98 00 02 04 06
Number of Persons Living with HIV Number of AIDS Cases/Deaths Year of Diagnosis/Death
Cases Deaths Persons Living with HIV/AIDS
– Personal and community
treatment
– Education – Diet – Exercise – Drug use – Smoking
– Definition of a couple – Design, data collection, and analysis
derail adherence?
Relationship Factors and HIV Treatment Adherence
R01NR010187
2006- 2007
2008
2008- 2010
2009- 2013
2012- 2015
He’s so pissed. He goes, “Well,” when he finds out, especially last week when I missed four days in a row, “God damn it.” And he goes, “I’m going to have to just light up your cell phone. I don’t care what you’re doing, you know, whatever you’re doing you’re going to drop what you’re doing and take your pills.” He said, “I’m going to call you between ten and one everyday, just light up your phone until you tell me you’ve taken your pills.” But ever since then I’ve been taking them so when he does call, “Yeah, I took them.” So that’s it.
He doesn't need me to stand behind him to take
so well, is because you know what, if he decides one day that he doesn't want to take it, I’m not going to push him on it, okay? Because it’s his choice whether he wants to take it, okay? It’s his body, it’s his temple.
Partner A:
“I like the daddy type and he certainly is—he’s that type, looks, and personality.”
Partner B:
“Well, I certainly love him. He’s very dependent, which I don’t mind. I mean, I don’t mind being a parent.” “We seem to be very compatible, because he pushes me around and I let him.
Paul’s Stuff Phil’s Stuff Phil’s Outcomes Paul’s Outcomes
Actor Effect Actor Effect
Paul’s Stuff Phil’s Stuff Phil’s Outcomes Paul’s Outcomes
Paul’s Stuff Phil’s Stuff Phil’s Outcomes Paul’s Outcomes Actor Effect Actor Effect
– Together at least 3 months
– Separate – “Smell check” for fake couples
– General med concerns – Specific concerns – Specific necessity
–Satisfaction –Autonomy –Intimacy –Equality –Commitment –Communication
– Integration – Perseverance
– 3 day – 30 day
– Detectable v not – Log10 transformed
– Multivariate using p<.25 for inclusion – All results are p<.05 in adjusted models
– Relationship Length – Living Together – Time on ART – Age – Number of pills per day
PAUL’s
Concerns about Meds (-) Autonomy
Age Time on Meds (-)
PHIL’s
Depression (-)
PAUL’s
Adherence Self Efficacy INTEGRATION
PAUL’s
General Med Concerns (-) Specific Med Concerns (-) Depression (-) Autonomy Intimacy
Time on Meds (-)
PHIL’s
Relationship Satisfaction
PAUL’s
Adherence Self- Efficacy PERSEVERANCE
PAUL’s
General Med Concerns (-)
Fewer pills per day
PHIL’s
Beliefs that Paul’s meds are necessary
PAUL’s
3 DAY ADHERENCE
PAUL’s
Relationship Communication
Time on meds (-)
PHIL’s
General Concerns about Meds (-)
PAUL’s
30 DAY ADHERENCE
PAUL’s
NOTHING
Time in relationship (-)
PHIL’s
Commitment (-)
PAUL’s
Detectable Viral Load
PAUL’s
NOTHING
PHIL’s
Commitment (-)
PAUL’s
Viral Load
– Self Efficacy for Adherence – Self-Reported Adherence – Viral load
– Depression – Treatment beliefs (general and specific) – Relationship factors (autonomy, commitment, satisfaction, intimacy, and communication)
adherence
adherence
–6, 12, 18, and 24 months –Include break up interviews
Paul’s Stuff Phil’s Stuff Phil’s Outcomes Paul’s Outcomes Actor Effect Actor Effect
Paul’s Stuff Phil’s Stuff Phil’s Outcomes Paul’s Outcomes
Partner A á QOL/ Well-Being á Coping/Problem solving â Substance Use Couple á Relationship Quality á Relationship Satisfaction á Intimacy á Communication â Conflict Partner B á QOL/ Well-Being á Coping/Problem Solving â Substance Use Partner A Support Provided á Overall Support Provided á Positive Tactics â Negative Tactics Partner A Support Received á Overall Support Received á Positive Tactics â Negative Tactics Partner B Support Received á Overall Support Received á Positive Tactics â Negative Tactics Partner B Support Provided á Overall Support Provided á Positive Tactics â Negative Tactics Partner A á Adherence Partner B á Adherence Partner A á CD 4 â Viral Load Partner B á CD 4 â Viral Load
Figure 1. Conceptual Model
2006- 2007
2008
2008- 2010
2009- 2013
2012- 2015
– Loved, valued, pleased, inspired? – Anxious, irritated?
Dyadic Data Analysis
0 = not true to 10= very true
Paul says 10 Phil says 2 Sum = 12 Difference = 8 Peter says 6 Ned says 6 Sum = 12 Difference = 0
– Tor Neilands – Lynae Darbes – Megan Comfort – Joey Taylor – Fantastic recruiters, interviewers and phlebotomists
Relationship Factors and HIV Treatment Adherence
Mallory O. Johnson, Ph.D.
Center for Health, Intervention, and Prevention Nov. 18, 2010