Social position, gender role, and treatment adherence among Colombian women living with HIV/AIDS: social determinants of health approach Posición social, papel de género y adhesión al tratamiento en mujeres colombianas con VIH/sida: enfoque de los determinantes sociales de la salud

• Main Authors: Marcela Arrivillaga, Michael Ross, Bernardo Useche, Martha Lucia Alzate, Diego Correa
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2009
• Subjects: Cooperación del paciente; VIH; SIDA; identidad de género; Colombia; Patient compliance; HIV; AIDS; gender identity; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Sida
• Online Access: https://doaj.org/article/a0fd35ecaa554ad7bd87420b7681083f

OBJECTIVE: To assess and analyze the associations between adherence to treatment and social position in women living with HIV/AIDS. METHOD: A cross-sectional, descriptive, correlational study among 269 Colombian women was conducted. Participants completed three questionnaires: a socio-demographic and clinical characteristics survey, a treatment adherence scale, and a social position survey. RESULTS: Women of low social position had a significantly higher probability of low treatment adherence (OR = 5.651, P < 0.0001), and the majority of social position variables measured had a significant effect on adherence. A general model considering the variables "type of national health care plan" ("contributive," "subsidized," or, in the case of vinculadas or the uninsured, "none"); "having HIV-positive children"; and "level of viral load" was statistically reliable in predicting study participants' treatment adherence. Membership in the subsidized plan or being uninsured had a greater effect on the probability of low adherence than membership in the contributive plan (OR = 3.478, P < 0.0001). Univariate regression analyses confirmed that women with HIV-positive children and a viral load > 400 copies/ml were more likely to have low adherence than women without those characteristics (OR = 2.395, P = 0.0274 and OR = 2.178, P = 0.0050, respectively). CONCLUSIONS: Improving women's adherence to HIV/AIDS treatment in Colombia would require eliminating barriers to national health care system and comprehensive health care services and implementing programs that take into account women's role as maternal caregivers The findings underscore the need to integrate variables related to gender inequality and social position in treatment adherence analysis, as advocated in the social determinants of health approach. OBJETIVO: Evaluar y analizar las asociaciones existentes entre la adhesión al tratamiento y la posición social de las mujeres con VIH/sida. MÉTODOS: Se realizó un estudio transversal, descriptivo y correlacional con ...