A systematic comparison of additive and interaction approaches to modeling the effects of syndemic problems on HIV outcomes in South Africa.
Much of the research on the effects of syndemics on HIV outcomes has utilized an additive approach. However, interaction effects may better account for syndemic synergy than an additive approach, but it remains difficult to specify interaction effects without empirical guidance. We sought to systema...
| Publicado en: | Journal of Behavioral Medicine Vol. 47; no. 6; pp. 1028 - 1040 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180457657&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180457657 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01607715 JBM jtl: Journal of Behavioral Medicine issn: 01607715 maglogo: N pubinfo: dt: Dec2024 vid: 47 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 180457657 179732858 180457657 180457657 10.1007/s10865-024-00517-y 180457657 ppf: 1028 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: A systematic comparison of additive and interaction approaches to modeling the effects of syndemic problems on HIV outcomes in South Africa. aug: au: Lee, Jasper S. Bainter, Sierra A. Tsai, Alexander C. Andersen, Lena S. Stanton, Amelia M. Magidson, Jessica F. Kagee, Ashraf May, Julian Joska, John A. O'Cleirigh, Conall Safren, Steven A. affil: https://ror.org/002pd6e78 Department of Psychiatry, Behavioral Medicine Program, Massachusetts General Hospital, One Bowdoin Square 9th Floor, 02114, Boston, MA, USA sug: subj: HIV Infections Drug Therapy Anti-Retroviral Agents Therapeutic Use Medication Compliance Evaluation Syndemic Human South Africa HIV-Positive Persons Linear Regression Alcohol Drinking Intimate Partner Violence Stress Disorders, Post-Traumatic Social Anxiety Disorders Substance Use Disorders Food Security Poverty Housing Instability Health Services Accessibility Depression Descriptive Statistics Confidence Intervals Funding Source ab: Much of the research on the effects of syndemics on HIV outcomes has utilized an additive approach. However, interaction effects may better account for syndemic synergy than an additive approach, but it remains difficult to specify interaction effects without empirical guidance. We sought to systematically compare additive and interaction effects approaches to modeling the effects of syndemic problems on antiretroviral therapy (ART) using empirically specified interaction terms. Participants were 194 people with HIV (PWH) who received HIV care in Khayelitsha, South Africa. In a series of linear regression models, we examined ten syndemic problems: depression, alcohol use, intimate partner violence (IPV), post-traumatic stress, social anxiety, substance use, food insecurity, poverty, housing instability, and structural barriers to care. Depression, substance use, and food insecurity were selected for interaction terms based on a prior network analysis, which found these problems to be most central. The additive models did not produce statistically significant findings. However, the interaction effects models yielded significant interaction terms in both the full model and a parsimonious model. There was a statistically significant effect of the interaction between depression and food insecurity on ART adherence (b = 0.04, Robust SE = 0.02, 95%CI [0.001–0.08], p =.012). This pattern of results was replicated in the parsimonious model. Findings suggest that when feasible, interaction effects approaches may be a helpful syndemic modeling technique. Results may inform future intervention targets, such as depression and food insecurity, and the importance of addressing both structural and psychosocial syndemic problems. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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