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With a focus on learning, we employ a range of strategies to support innovation, collaboration across centers, and university-wide discussion and decision-making

 

Fifteenth Annual Grant Winners 2014-2015

Title

Effects of Type 2 Diabetes on Antiretroviral Adherence in Older Adults with HIV

Dean

Lisa Deziel, Ph.D., Pharm.D. (HPD-PHR)
Anthony Silvagni, D.O.,Pharm.D. (HPD-OST)
Linda Niessen, DMD, MPH, MPP (HPD-DEN)

Faculty and Students

Joshua Caballero, Pharm.D. (HPD-PHR)
Robin J. Jacobs, Ph.D. (HPD-OST)
Jennifer E. Thomas (HPD-PHR)
Raymond L. Ownby, MD, Ph.D., MBA (HPD-OST)
Mark Schweizer, D.D.S. (HPD-DEN)
Ana Vega, BS (HPD-PHR)

Abstract

One of the fastest growing populations infected with HIV are adults aged 65 and older. Recent data show the rates are likely to increase dramatically, especially for Broward County which contains one of the largest populations of older adults with HIV in the United States. Current antiretroviral therapy have prolonged life expectancy of persons with HIV and made the disease more manageable. However, for therapy to be effective, persons need to be 80-95% adherent. Unfortunately, as persons with HIV age, they may experience neurocognitive disorders which can impair memory, behavior, and motor function. Additionally, they are prone to developing chronic conditions, such as type 2 diabetes (T2D) which can further impact memory. As a result, the additive effects of HIV and T2D on cognition may alter the ability for older adults to maintain appropriate levels of antiretroviral medication adherence. This can have dire consequences since poor adherence can increase rates of transmission to other individuals, cause drug resistance, and increase morbidity and mortality in this population. Older adults with HIV may also have depression or poor health literacy that may further impact adherence. Therefore, the purpose of this study is to evaluate the difference between antiretroviral medication adherence in HIV-positive older adults (i.e., persons aged 65 and older) with and without T2D. Additionally, we will assess if heath literacy and cognition play a role in their adherence. We will evaluate the primary objective (difference in antiretroviral adherence between both groups), via two-tailed independent groups t-tests. We will assess objectives 2 and 3, (cognitive function or health literacy scales correlates with antiretroviral adherence), via multiple regression analysis. The results of this study will assist us in submitting for future funding at the national level in an area that has been understudied but that may have dire consequences in the near future.