Psychosocial Syndemics are Additively Associated with Worse ART Adherence in HIV-Infected Individuals

Aaron J. Blashill, C. Andres Bedoya, Kenneth H. Mayer, Conall O’Cleirigh, Megan M. Pinkston, Jocelyn E. Remmert, Matthew J. Mimiaga, Steven A. Safren

Research output: Contribution to journalArticlepeer-review

71 Scopus citations


Adherence to antiretroviral therapy (ART) among HIV-infected individuals is necessary to both individual and public health, and psychosocial problems have independently been associated with poor adherence. To date, studies have not systematically examined the effect of multiple, co-occurring psychosocial problems (i.e., “syndemics”) on ART adherence. Participants included 333 HIV-infected individuals who completed a comprehensive baseline evaluation, as part of a clinical trial to evaluate an intervention to treat depression and optimize medication adherence. Participants completed self-report questionnaires, and trained clinicians completed semi-structured diagnostic interviews. ART non-adherence was objectively measured via an electronic pill cap (i.e., MEMS). As individuals reported a greater number of syndemic indicators, their odds of non-adherence increased. Co-occurring psychosocial problems have an additive effect on the risk for poor ART adherence. Future behavioral medicine interventions are needed that address these problems comprehensively, and/or the core mechanisms that they share.

Original languageEnglish (US)
Pages (from-to)981-986
Number of pages6
JournalAIDS and Behavior
Issue number6
StatePublished - Oct 21 2015
Externally publishedYes


  • ART
  • Adherence
  • Antiretroviral therapy
  • Comorbidity
  • HIV
  • Syndemics

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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