Adherence to antiretroviral therapy (ART) is essential for the effective management of HIV, which includes keeping the HIV viral load undetectable. This study aimed to determine whether certain ART medications are more “forgiving” of poor adherence in achieving viral suppression. We identified subgroups of ART medication usage and determined the extent to which ART adherence is associated with viral suppression across those subgroups. Data came from claims and clinical records (2017–2019) of 3,552 HIV-positive adult members of a Medicaid managed care plan. Pharmacy fill data were examined to characterize ART medications using latent class analysis (LCA), which captures the complexity of real-world ART usage (i.e., multiple medications, ART switching). LCA yielded five ART medication patterns over three years, mostly characterized by recent medications and formulations of ART, though they varied in number of tablets and in medication class. Mixed effects logistic regression models were estimated to determine whether odds of viral suppression differed by ART adherence level. After adjusting for covariates, those with at least 90% adherence (i.e., 90 to < 95%) did not significantly differ from those with 95% adherence or greater in terms of viral suppression, which corroborates existing clinical recommendations. These findings can inform provider-patient communication for people with HIV, especially those who have difficulty maintaining adherence. This includes those experiencing unstable housing, mental health conditions, or substance use.

Caregivers of children with rare diseases often consider caregiving to be a rewarding experience, despite high levels of burden. The present study examined associations between caregiver stress and...

Personal networks undergo changes in structure and composition throughout the life span, adapting to developmental transitions and changing circumstances in a dynamic way. This study examines stability and change in social convoys from childhood to adulthood and variation in trajectories of convoy characteristics by gender and race. Multilevel models for convoy structure and composition characteristics were estimated using three waves of longitudinal data spanning 23 years. The regionally representative sample included 193 children aged 8 to 12 in Wave 1 (1992) who were surveyed again in their 20s (Wave 2) and 30s (Wave 3). The Wave 1 sample comprised 52% girls, 32% Black children, and 59% White children with average maternal educational attainment of 13 years. Overall, changes in composition, proximity, and contact frequency were observed at each wave. Between Waves 1 and 2, the changes reflect age-normative trends toward network diversification typical of the transition to adulthood, whereas between Waves 2 and 3, the changes were consistent with those expected as young adults settle into stable roles. We also identified convoy characteristics that differed between men and women and between Black and White individuals, emphasizing the importance of considering personal characteristics to fully understand form and function of social relations. Social convoy trajectories early in the life span provide direction for more in-depth examinations of the implications of social ties during these critical life periods. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The present study expanded upon existing literature to investigate a broader construct of negativity, marital tension, and its implications for marital well-being across the early years of marriage. Marital tension captures feelings of irritation, resentment, and disappointment surrounding the relationship, and is distinct from conflict and specific conflict strategies. Longitudinal data spanning 16 years from the Early Years of Marriage Study (n = 373 couples) were analyzed using actor-partner interdependence models. Competing hypotheses derived from the enduring dynamics and emergent distress models of marriage were tested using measures of both partners' marital tension in Year 1 of marriage, as well as changes in marital tension from Year 1. Husbands and wives who reported greater marital tension in Year 1 of marriage, or showed increases in tension from Year 1, reported lower marital well-being. The link between respondents' own Year 1 tension and marital well-being was strengthened by their partners' reports of tension, but an amplification effect of both partners' changes in marital tension was observed only among wives. These results persisted even after accounting for the influence of destructive conflict. Findings provide evidence for both models of marriage, indicating that negativity should be assessed more broadly, include both members of the couple, and recognize the critical role of early marital tension as well as increased tension for marital well-being. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Caregiving networks of individuals with Alzheimer’s disease and related dementias (ADRD) are comprised of family and friends directly involved in caregiving activities and those supporting these activities. The purpose of this study was to investigate whether caregiving-related behaviors and interactions (i.e., uplift, malfeasance, and nonfeasance), kinship tie (i.e., friend, family), and family history of ADRD were associated with caregivers’ emotional support networks. Seventy-one caregivers across 30 families provided information about 776 network members. Perceived emotional support and interactions representing uplift, malfeasance, and nonfeasance were assessed. Results indicated that uplift and friendship were associated with increased, whereas nonfeasance was associated with decreased, likelihood of perceived emotional support. Caregivers with a family history of ADRD were particularly more likely to report emotional support from friends and uplifting network members. Findings suggest the need for differential strategies based on families’ prior caregiving experience to facilitate positive and minimize negative interactions within caregiving networks.