@article{656d9aa7eabc42038d5d7da2c1ad4478,
title = "Perceptions About Local ART Adherence Norms and Personal Adherence Behavior Among Adults Living with HIV in Rural Uganda",
abstract = "Although misperceived norms often drive personal health behaviors, we do not know about this phenomenon in the context of antiretroviral therapy (ART) adherence. We conducted a cross-sectional study including all persons living with HIV (PLWH) on ART across eight villages in one parish in a rural region of southwestern Uganda. We used surveys to measure personal reports of ART adherence (not missing any doses of ART in the past 7 days was considered optimal adherence whereas missing doses was considered suboptimal adherence) and perceived norms about the local ART adherence norm (whether or not each individual thought {\textquoteleft}most other PLWH on ART in this parish{\textquoteright} missed any doses in the past 7 days). Multivariable Poisson regression models were used to estimate the association between perceived norms and personal adherence. Among 159 PLWH on ART (95% response rate), 142 (89%) reported no missed doses. However, 119 (75%) thought most individuals in this population of PLWH on ART were sub-optimally adherent. This misperception about the local ART adherence norm was prevalent in every subgroup of PLWH. Misperceiving the local ART adherence norm to be sub-optimal adherence was associated with a reduced likelihood of optimal adherence among married PLWH (adjusted relative risk [aRR] = 0.83; 95% confidence interval [CI] 0.71–0.97). The association was similar but imprecisely estimated for all PLWH (aRR = 0.91; 95% CI 0.82–1.01). Interventions to correct misperceived ART adherence norms as a stand-alone intervention or as a complement to other adherence promotion programs may influence ART adherence behavior and perhaps reduce HIV-related stigma.",
keywords = "Antiretroviral therapy, Descriptive norms, Social networks, Social norms, Stigma",
author = "Perkins, {Jessica M.} and Bernard Kakuhikire and Charles Baguma and Rasmussen, {Justin D.} and Satinsky, {Emily N.} and Allen Kiconco and Justus Kananura and Audet, {Carolyn M.} and Siedner, {Mark J.} and Haberer, {Jessica E.} and Bangsberg, {David R.} and Tsai, {Alexander C.}",
note = "Funding Information: This study was funded by grants from Friends of a Healthy Uganda and U.S. National Institutes of Health (NIH) R01MH113494 to ACT. This work was also partially supported by the NIH-funded Tennessee Center for AIDS Research (P30 AI110527). JMP acknowledges salary support from NIH K01MH115811. JEH acknowledges salary support from NIH K24MH114732. Funding Information: We thank the HopeNet cohort study participants, without whom this research would not be possible. We also thank members of the HopeNet study team for research assistance; in addition to the named study authors, HopeNet and other collaborative team members who contributed to data collection and/or study administration during all or any part of the study were as follows: Owen Alleluya, Patience Ayebare, Dickson Beinomugisha, Bridget Burns, Patrick Gumisiriza, Clare Kamagara, Elizabeth Namara, Phionah Ahereza, Juliet Mercy, Patrick Lukwago Muleke, Rhina Mushagara, Rumbidzai Mushavi, Elijah Musinguzi, Moran Owembabazi, Sarah Nabachwa, Immaculate Ninsiima, Mellon Tayebwa, and Dagmar Vo{\v r}echovsk{\'a}. We also thank Roger Hofmann of West Portal Software Corporation (San Francisco, CA, USA), for developing and customizing the Computer Assisted Survey Information Collection Builder software program used to collect the survey and social network data. We also thank Claire Evans who contributed research assistance in finalizing the manuscript. Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",
year = "2022",
month = jun,
doi = "10.1007/s10461-021-03540-1",
language = "English (US)",
volume = "26",
pages = "1892--1904",
journal = "AIDS and Behavior",
issn = "1090-7165",
publisher = "Springer New York",
number = "6",
}