StressCovidV1, Main, Exploration, bibRecord, 002129

Educational attainment and response to HAART during initial therapy for HIV-1 infection

Identifieur interne : 002129 ( Main/Exploration ); précédent : 002128; suivant : 002130

Educational attainment and response to HAART during initial therapy for HIV-1 infection

Auteurs : Linda G. Marc [États-Unis] ; Marcia A. Testa [États-Unis] ; Alexander M. Walker [États-Unis] ; Gregroy K. Robbins [États-Unis] ; Robert W. Shafer [États-Unis] ; Norman B. Anderson [États-Unis] ; Lisa F. Berkman [États-Unis]

Source :

Journal of psychosomatic research [ 0022-3999 ] ; 2007.

RBID : Pascal:07-0489642

Descripteurs français

Pascal (Inist)
- Antirétroviral, Antiviral, Association médicamenteuse, Coping, Efficacité personnelle, Environnement social, Etude multicentrique, Facteur prédictif, Homme, International, Niveau étude, Observance médicamenteuse, Pharmacothérapie, SIDA, Santé mentale, Santé publique, Statut socioéconomique, Stress, Coping, Antirétroviral, Association médicamenteuse, Traitement, SIDA, Observance médicamenteuse, Efficacité personnelle, Virus immunodéficience humaine, Statut socioéconomique, Facteur prédictif, Etude multicentrique, International, Santé publique, Santé mentale, Environnement social, Homme, Antiviral, Pharmacothérapie.
Wicri :
- topic : Homme, Santé mentale, Santé publique, Santé mentale, Homme.

English descriptors

KwdEn :
- AIDS, Antiretroviral agent, Antiviral, Coping, Drug combination, Drug compliance, Education level, Human, Human immunodeficiency virus, International, Mental health, Multicenter study, Pharmacotherapy, Predictive factor, Public health, Self efficacy, Social environment, Socioeconomic status, Stress, Treatment.

Abstract

Objective: Previous research has demonstrated an association between educational attainment (EA) and negative physical and psychological outcomes. This study investigated whether EA is associated with regimen failure during initial therapy with highly active antiretroviral treatment (HAART) and whether adherence self-efficacy (ASE), a coping resource, moderates the relationship between EA and regimen failure. Methods: A secondary analysis of AIDS Clinical Trial Group Protocol 384, an international, multi-center, randomized, partially double-blinded trial, included 799 male and 181 female antiretroviral-naïve subjects (age, 37.0±9.5 years). Participants were recruited from 1998 to 1999 and followed for a median of 2.3 years across 81 centers. The dependent variable was "time to first regimen failure." Covariates include baseline HIV-1 log₁₀RNA and CD4⁺ counts, self-reported adherence, study site, ASE, age, sex, race, treatment assignment, and baseline use of nonantiretroviral medications. Results: ASE significantly moderated the relationship between EA and regimen failure. Results showed that for every 10-unit increase in ASE, individuals with "less than high school" education had a 17% reduction in regimen failure (hazard ratio=0.83; 95% confidence interval=0.70-0.98) when compared to the reference group "college/graduate," even after adjusting for baseline factors known to contribute to regimen failure. The time to first regimen failure was shorter with decreasing EA, trending toward significance (P=.08). Conclusions: There is a social gradient in HAART effectiveness, and ASE reduces the deleterious effects of lower EA on regimen failure. We recommend designing controlled interventions to evaluate the effectiveness of programs that increase ASE prior to initiation with HAART, particularly for those with lower EA.

Affiliations:

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term>
<term>Antiretroviral agent</term>
<term>Antiviral</term>
<term>Coping</term>
<term>Drug combination</term>
<term>Drug compliance</term>
<term>Education level</term>
<term>Human</term>
<term>Human immunodeficiency virus</term>
<term>International</term>
<term>Mental health</term>
<term>Multicenter study</term>
<term>Pharmacotherapy</term>
<term>Predictive factor</term>
<term>Public health</term>
<term>Self efficacy</term>
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<term>Socioeconomic status</term>
<term>Stress</term>
<term>Treatment</term>
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<term>Antiviral</term>
<term>Association médicamenteuse</term>
<term>Coping</term>
<term>Efficacité personnelle</term>
<term>Environnement social</term>
<term>Etude multicentrique</term>
<term>Facteur prédictif</term>
<term>Homme</term>
<term>International</term>
<term>Niveau étude</term>
<term>Observance médicamenteuse</term>
<term>Pharmacothérapie</term>
<term>SIDA</term>
<term>Santé mentale</term>
<term>Santé publique</term>
<term>Statut socioéconomique</term>
<term>Stress</term>
<term>Coping</term>
<term>Antirétroviral</term>
<term>Association médicamenteuse</term>
<term>Traitement</term>
<term>SIDA</term>
<term>Observance médicamenteuse</term>
<term>Efficacité personnelle</term>
<term>Virus immunodéficience humaine</term>
<term>Statut socioéconomique</term>
<term>Facteur prédictif</term>
<term>Etude multicentrique</term>
<term>International</term>
<term>Santé publique</term>
<term>Santé mentale</term>
<term>Environnement social</term>
<term>Homme</term>
<term>Antiviral</term>
<term>Pharmacothérapie</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
<term>Santé mentale</term>
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<term>Santé mentale</term>
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<front><div type="abstract" xml:lang="en">Objective: Previous research has demonstrated an association between educational attainment (EA) and negative physical and psychological outcomes. This study investigated whether EA is associated with regimen failure during initial therapy with highly active antiretroviral treatment (HAART) and whether adherence self-efficacy (ASE), a coping resource, moderates the relationship between EA and regimen failure. Methods: A secondary analysis of AIDS Clinical Trial Group Protocol 384, an international, multi-center, randomized, partially double-blinded trial, included 799 male and 181 female antiretroviral-naïve subjects (age, 37.0±9.5 years). Participants were recruited from 1998 to 1999 and followed for a median of 2.3 years across 81 centers. The dependent variable was "time to first regimen failure." Covariates include baseline HIV-1 log<sub>10</sub>
RNA and CD4<sup>+</sup>
 counts, self-reported adherence, study site, ASE, age, sex, race, treatment assignment, and baseline use of nonantiretroviral medications. Results: ASE significantly moderated the relationship between EA and regimen failure. Results showed that for every 10-unit increase in ASE, individuals with "less than high school" education had a 17% reduction in regimen failure (hazard ratio=0.83; 95% confidence interval=0.70-0.98) when compared to the reference group "college/graduate," even after adjusting for baseline factors known to contribute to regimen failure. The time to first regimen failure was shorter with decreasing EA, trending toward significance (P=.08). Conclusions: There is a social gradient in HAART effectiveness, and ASE reduces the deleterious effects of lower EA on regimen failure. We recommend designing controlled interventions to evaluate the effectiveness of programs that increase ASE prior to initiation with HAART, particularly for those with lower EA.</div>
</front>
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<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Californie</li>
<li>District de Columbia</li>
<li>Massachusetts</li>
<li>État de New York</li>
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<tree><country name="États-Unis"><region name="État de New York"><name sortKey="Marc, Linda G" sort="Marc, Linda G" uniqKey="Marc L" first="Linda G." last="Marc">Linda G. Marc</name>
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<name sortKey="Anderson, Norman B" sort="Anderson, Norman B" uniqKey="Anderson N" first="Norman B." last="Anderson">Norman B. Anderson</name>
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<name sortKey="Berkman, Lisa F" sort="Berkman, Lisa F" uniqKey="Berkman L" first="Lisa F." last="Berkman">Lisa F. Berkman</name>
<name sortKey="Marc, Linda G" sort="Marc, Linda G" uniqKey="Marc L" first="Linda G." last="Marc">Linda G. Marc</name>
<name sortKey="Marc, Linda G" sort="Marc, Linda G" uniqKey="Marc L" first="Linda G." last="Marc">Linda G. Marc</name>
<name sortKey="Robbins, Gregroy K" sort="Robbins, Gregroy K" uniqKey="Robbins G" first="Gregroy K." last="Robbins">Gregroy K. Robbins</name>
<name sortKey="Shafer, Robert W" sort="Shafer, Robert W" uniqKey="Shafer R" first="Robert W." last="Shafer">Robert W. Shafer</name>
<name sortKey="Testa, Marcia A" sort="Testa, Marcia A" uniqKey="Testa M" first="Marcia A." last="Testa">Marcia A. Testa</name>
<name sortKey="Walker, Alexander M" sort="Walker, Alexander M" uniqKey="Walker A" first="Alexander M." last="Walker">Alexander M. Walker</name>
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Educational attainment and response to HAART during initial therapy for HIV-1 infection

Educational attainment and response to HAART during initial therapy for HIV-1 infection

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