Date of Graduation

Summer 8-15-2023

Document Type

Dissertation

Degree Name

Doctor of Psychology in Clinical Psychology (PsyD)

College/School

School of Nursing and Health Professions

Program

Clinical Psychology (PsyD)

First Advisor

Dellanira Garcia, PhD

Second Advisor

Michelle Montagno, PsyD

Third Advisor

William Hua, PhD

Abstract

The human immunodeficiency virus (HIV) continues to affect Latinx men who have sex with men (MSM). Interventions have been developed to improve antiretroviral therapy (ART) adherence, but little is known about the number of available interventions and their effectiveness to assist Latinx MSM. The current systematic review investigated the effects of interventions aimed at improving ART adherence for the treatment of adult Latinx MSM with HIV in the United States. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to communicate the results. The inclusion criteria comprised Latinx MSM with HIV, any type of intervention with an ART adherence outcome, a comparison group, and quantitative data. Records were obtained from PubMed, PsycINFO, CINAHL, SCOPUS, ProQuest, and Google Scholar on April 21, 2022, and additional records were gathered through other sources. The final sample entailed 4 studies with 3 interventions, and the ROBINS-I and the RoB 2 were utilized to assess risk of bias. Among the 3 interventions, only one was specifically tailored for Latinx MSM with HIV. All 3 interventions were delivered in Spanish and targeted Spanish-speaking Latinx groups in Los Angeles and New York City. Adherence to ART improved in the short-term but it was not sustained over time. None of the interventions included the examination of depressive symptomatology, which is a non-adherence factor among Latinx MSM. The three interventions are not inclusive of language and cultural differences among Latinx MSM with HIV and may not be generalizable to other cities, as they were conducted in Los Angeles and New York City. The three interventions are not comprehensive by integrating ancillary services to increase ART adherence, which may explain why improvements in adherence were not sustained long-term. The scarcity of ART adherence interventions place Latinx MSM at a disadvantage in reducing their HIV viral load by improving their adherence. More ART adherence interventions for Latinx MSM are warranted. Greater initiatives and investment are needed to assist Latinx MSM with HIV and to address the current gap in the field of ART adherence interventions.

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