Risk Factors for Non-Adherence to cART in Immigrants with HIV Living in the Netherlands: Results from the ROtterdam ADherence (ROAD) Project

Sabrina K Been*, David A M C van de Vijver, Pythia T Nieuwkerk, Inês Brito, Sarah E. Stutterheim, Arjan E R Bos, Mireille E G Wolfers, Katalin Pogány, Annelies Verbon

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


In the Netherlands, immigrant people living with HIV (PLWH) have poorer psychological and treatment outcomes than Dutch PLWH. This cross-sectional field study examined risk factors for non-adherence to combination Antiretroviral Therapy (cART) among immigrant PLWH. First and second generation immigrant PLWH attending outpatient clinics at two HIV-treatment centers in Rotterdam were selected for this study. Socio-demographic and clinical characteristics for all eligible participants were collected from an existing database. Trained interviewers subsequently completed questionnaires together with consenting participants (n = 352) to gather additional data on socio-demographic characteristics, psychosocial variables, and self-reported adherence to cART. Univariable and multivariable logistic regression analyses were conducted among 301 participants who had used cART ≥6 months prior to inclusion. Independent risk factors for self-reported non-adherence were (I) not having attended formal education or only primary school (OR = 3.25; 95% CI: 1.28-8.26, versus University), (II) experiencing low levels of social support (OR = 2.56; 95% CI: 1.37-4.82), and (III) reporting low treatment adherence self-efficacy (OR = 2.99; 95% CI: 1.59-5.64). Additionally, HIV-RNA >50 copies/ml and internalized HIV-related stigma were marginally associated (P<0.10) with non-adherence (OR = 2.53; 95% CI: 0.91-7.06 and OR = 1.82; 95% CI: 0.97-3.43). The findings that low educational attainment, lack of social support, and low treatment adherence self-efficacy are associated with non-adherence point to the need for tailored supportive interventions. Establishing contact with peer immigrant PLWH who serve as role models might be a successful intervention for this specific population.

Original languageEnglish
Article numbere0162800
Issue number10
Publication statusPublished - 2016


  • Adult
  • Anti-HIV Agents/therapeutic use
  • Antiretroviral Therapy, Highly Active
  • Cross-Sectional Studies
  • Databases, Factual
  • Emigrants and Immigrants/psychology
  • Female
  • HIV/genetics
  • HIV Infections/drug therapy
  • Humans
  • Interviews as Topic
  • Logistic Models
  • Male
  • Medication Adherence/statistics & numerical data
  • Middle Aged
  • Netherlands
  • Odds Ratio
  • RNA, Viral/blood
  • Risk Factors
  • Self Efficacy
  • Self Report
  • Social Support
  • Young Adult


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