Observational studyAIDS care2025
The reciprocal relationships between loneliness and antiretroviral therapy adherence in persons with HIV: a two-wave cross-lagged model.
Observational study in AIDS care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 authors.
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Abstract
Loneliness has been linked to medication-taking behaviors in the general population, yet its role in antiretroviral therapy (ART) adherence among persons with HIV (PWH) remains less understood. This study examined whether loneliness is a risk factor for, or consequence of, poor ART adherence. We conducted a secondary analysis of an observational study on racial disparities in health outcomes among PWH in the Southeastern United States. A cross-lag model tested reciprocal relationships between loneliness (PROMIS-Social Isolation Scale) and self-reported ART adherence across two time points (baseline and 6-month follow-up). Complete cases on both variables yielded a sample of 153 participants (mean age=46.3; 28.1% female; 64.7% Black). Adjusting for depressive symptoms, life stressors, HIV-related stigma and age, the results indicated that baseline loneliness predicted greater loneliness at follow-up (β=0.68, p<.001) and lower ART adherence (β=-0.28, p=.003). Baseline adherence predicted future adherence (β=0.36, p<.001) but not future loneliness (β=0.02, p=.73). Older age was positively associated with adherence (β=0.16, p=.02). The findings suggest that loneliness undermines ART adherence over time, highlighting the need for interventions in community and clinical settings that address loneliness to improve long-term HIV care outcomes.
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