Date of Conferral

2020

Degree

Doctor of Public Health (DrPH)

School

Health Services

Advisor

Kai Stewart

Abstract

Young adults, especially African American men who have sex with men (MSM) have the lowest rates of antiretroviral therapy (ART) adherence among all age groups; however, they experience greater than 50% of all new Human Immunodeficiency Virus (HIV) infections among individuals 13 to 24 years of age. Despite the availability of ART, young MSM continue to experience suboptimal rates of adherence and are one of the most vulnerable populations for contracting HIV. Grounded in the social cognitive theory, my aim for this quantitative cross-sectional study was to investigate the relationship between diverse social determinants and ART adherence among young adult HIV+ MSM age 18-39 living in the state of Georgia (GA). Data obtained from the 2015 GA Medical Monitoring Project were used to conduct the study. The chi-square model revealed there was no relationship between ART awareness based on medication dose and schedule but there was a strong positive relationship between ART awareness and medication instruction adherence with a gamma of .674 (p =.04). The regression analysis showed race/ethnicity (p = .039) and educational attainment (p = .028) were predictors of medication instruction adherence. Whites (p < .029, OR = .168) had a higher likelihood of adhering to instructions than other races/ethnicities. Educational levels (p = .002) were predictors of medication schedule adherence and those with higher educational levels were more likely to adhere to medication instructions. These findings may lead to positive social change, as they may provide valuable knowledge about the association between factors that promote adherence and those that adversely contribute to suboptimal ART adherence among young HIV+ MSM.

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