{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T07:39:56Z","timestamp":1791013196768,"version":"4.1.0"},"reference-count":77,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Medication adherence contributes to poor HIV outcomes, especially among people with HIV and Substance use disorder (SUD). Mobile health applications have been leveraged to improve behavioral health outcomes among this population. Our cross-sectional study examined the relationship between medication adherence with factors such as treatment self-regulation, isolation, and internalized stigma, among people with HIV and SUD using the Addiction Comprehensive Health Enhancement Support System (A-CHESS) mobile app.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A sample of 208 participants using A-CHESS to improve treatment adherence completed a survey. Adherence was measured using the Four-item Morisky Medication Adherence Scale and dichotomized (maximum score of 20 points considered as adherent). Positive and negative affect was measured separately using Positive Affect Negative Affect Schedule and loneliness was measured using UCLA three-item Loneliness Scale. Internalized stigma was measured using Internalized AIDS-Related Stigma Scale. Competence\/Treatment self-regulation was measured using Treatment Self-regulation Questionnaire. Multivariable logistic regression was used to assess the associations of affect, treatment self-regulation, isolation, and internalized stigma, with adherence to antiretroviral therapy adjusting for age, education, and gender.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 208 participants in this study, most were Black (<jats:italic>n<\/jats:italic> = 137; 66%), male (<jats:italic>n<\/jats:italic> = 156; 75%) and had a mean age of 46 (standard deviation = 11.3). The most reported substances associated with missing HIV medication were alcohol (27%) and cocaine\/crack (20%). Logistic regression analysis revealed that internalized stigma was significantly associated with HIV medication adherence (OR = 0.82; 95% CI: 0.70\u20130.99; <jats:italic>p<\/jats:italic> = 0.034).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Internalized stigma was significantly associated with HIV medication adherence. Further research is needed to better understand this relationship and develop interventions addressing stigma in people with HIV and SUD.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1440807","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T04:48:04Z","timestamp":1730782084000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Associations of stigma, loneliness, and treatment self-regulation with HIV medication adherence among individuals with substance use disorder using a mobile health application"],"prefix":"10.3389","volume":"12","author":[{"given":"Adati","family":"Tarfa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarfa","family":"Verinumbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan (Ellie)","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olayinka O.","family":"Shiyanbola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Liebert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Dietz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan P.","family":"Westergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1007\/s10461-018-2278-z","article-title":"Non-planning impulsivity but not behavioral impulsivity is associated with HIV medication non-adherence","volume":"23","author":"Dunne","year":"2019","journal-title":"AIDS Behav."},{"key":"B2","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1097\/QAI.0000000000002142","article-title":"Antiretroviral adherence level necessary for HIV viral suppression using real-world data","volume":"82","author":"Byrd","year":"2019","journal-title":"J Acquir Immune Defic Syndr."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2331","DOI":"10.1177\/1049732320945296","article-title":"\u201cWhy am i not taking medications?","volume":"30","author":"Huang","year":"2020","journal-title":"Qual Health Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2109","DOI":"10.1097\/00002030-200111090-00006","article-title":"Effect of adherence to newly initiated antiretroviral therapy on plasma viral load","volume":"15","author":"Gross","year":"2001","journal-title":"AIDS."},{"key":"B5","doi-asserted-by":"publisher","first-page":"95","DOI":"10.18553\/jmcp.2020.26.2.95","article-title":"The effect of an integrated health system specialty pharmacy on HIV antiretroviral therapy adherence, viral suppression, and CD4 count in an outpatient infectious disease clinic","volume":"26","author":"Barnes","year":"2020","journal-title":"J Manag Care Spec Pharm."},{"key":"B6","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/1471-2288-15-10","article-title":"Impact of variability in adherence to HIV antiretroviral therapy on the immunovirological response and mortality","volume":"15","author":"Boussari","year":"2015","journal-title":"BMC Med Res Methodol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1080\/09540120412331305098","article-title":"Quality of life in HIV-infected individuals receiving antiretroviral therapy is related to adherence","volume":"17","author":"Mannheimer","year":"2005","journal-title":"AIDS Care."},{"key":"B8","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1097\/00126334-200203010-00004","article-title":"Quality of life, emotional status, and adherence of HIV-1-infected patients treated with efavirenz versus protease inhibitor-containing regimens","volume":"29","author":"Fumaz","year":"2002","journal-title":"J Acquir Immune Defic Syndr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"117","DOI":"10.2147\/HIV.S32321","article-title":"Quality of life of people living with HIV and AIDS and antiretroviral therapy","volume":"4","author":"Oguntibeju","year":"2012","journal-title":"HIV\/AIDS."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.15585\/mmwr.mm6848e1","article-title":"Vital signs: status of human immunodeficiency virus testing, viral suppression, and HIV preexposure prophylaxis - 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