Some Minorities With HIV, AIDS Were Least Likely to Take Rx

Side effects and stigma of antiretroviral therapy cited among chief concerns

(RxWiki News) According to new research, African-American and Latino people with HIV or AIDS were the least likely to take medication that could extend their lives. Researchers may now have some of the answers as to why.

A recent study revealed that concern about the side effects of antiretroviral therapy was one of the most common reasons why patients were not taking medication.

"Seek medical care if you have HIV or AIDS."

The research was led by Marya Gwadz, PhD, of the Center for Drug Use and HIV Research at New York University.

As many as 45 percent of people with HIV or AIDS delay, decline or discontinue therapy, the researchers reported.

The researchers recruited 95 participants found through peer recruitment and two clinics in New York City. They were interested in African-Americans and Latinos infected with HIV for at least six months who were not taking antiretroviral therapy. The investigators thought their reasons for not taking the therapy might be different from other populations.

The researchers initially found 4,758 individuals who met their criteria with HIV or AIDS at their clinics, but only 4.3 percent were not taking antiretroviral therapy. They enrolled 35 people from the clinics.

The study authors then found 60 individuals identified through peers in the community. They hypothesized that the HIV and AIDS communities were well-connected and that many of those in treatment at the clinics knew others with the disease from their personal lives.

On average, the 95 participants were 48 years old and had lived with HIV or AIDS for 14.7 years.

They conducted an hour-long interview with each subject. The interviewers asked about background information like age and tested subjects on their knowledge of HIV, their trust in the health care system, and their beliefs and feelings about antiretroviral therapy.

The researchers learned that, after initial diagnosis, 40 percent of participants had delayed entering treatment for six months or longer. Almost all (99 percent) had had antiretroviral therapy recommended to them.

The main reasons people in this group cited for not taking the therapy included concern about side effects, a change of mind, a change in life circumstances, difficulty adhering to the medication schedule and substance abuse.

About half of those interviewed gave other reasons, such as not being able to swallow pills or feeling there was a stigma attached to having the disease and taking the medication. Participants did not report difficulties obtaining the medications or getting refills.

Many participants had taken antiretroviral therapy in the past and may not have been aware that newer drugs had improved and caused fewer side effects, the investigators noted.

“We found that African-Americans and Latinos with HIV show great fear of antiretroviral therapy, particularly fear of side effects and the possibility that taking medication will reveal their HIV status to others, leading to stigma,” Dr. Gwadz said in a press statement. “They also report high levels of distrust of medications and the medical system.”

The researchers noted that their study was small, but they had gained some ideas as to how to help those declining antiretroviral therapy because of this study. They said they planned to test some strategies in the field, including support groups led by peers who are engaged in care and benefiting from antiretroviral therapy.

This study was published July 16 in Frontiers in Public HealthThe authors did not disclose any conflicts of interest.

Review Date: 
July 18, 2014