We compared adherence to cART and virological response between indigenous and immigrant HIV-infected patients in the Netherlands, and investigated if a possible difference was related to a difference in the psychosocial variables: HIV-stigma, quality-of-life, depression and beliefs about medications. Psychosocial variables were assessed using validated questionnaires administered during a face-to-face interview. Adherence was assessed trough pharmacy-refill monitoring. We assessed associations between psychosocial variables and non-adherence and having detectable plasma viral load using logistic regression analyses. Two-hundred-two patients participated of whom 112 (55%) were immigrants. Viral load was detectable in 6% of indigenous patients and in 15% of the immigrants (P < 0.01). In multivariate analyses, higher HIV-stigma and prior virological failure were associated with non-adherence, and depressive symptoms, prior virological failure and non-adherence with detectable viral load. Our findings suggest that HIV-stigma and depressive symptoms may be targets for interventions aimed at improving adherence and virological response among indigenous and immigrant HIV-infected patients. © 2011 The Author(s).

immigrants HIV stigma Virological response cART adherence Depressive symptoms

Netherlands depression HIV Infections Human immunodeficiency virus infection psychological aspect methodology human highly active antiretroviral therapy Antiretroviral Therapy, Highly Active middle aged statistics Viral Load comparative study social support ethnology interview quality of life Young Adult Humans virology Adolescent Interviews as Topic male Emigrants and Immigrants female Medication Adherence risk factor Risk Factors questionnaire Social Stigma Article patient compliance Questionnaires adult migration HIV-1 virus load patient attitude Human immunodeficiency virus 1 Patient Acceptance of Health Care drug effect anti human immunodeficiency virus agent Anti-HIV Agents