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Article

Characterization of Antiretroviral Therapy (ART) Adherence Phenotypes and Psychosocial Symptom Clusters Among Black/African American (AA) and Hispanic/Latine Adolescents and Young Adults (AYAs) with HIV in the Adherence Connection for Counseling, Education, and Support (ACCESS-II) Trial

by
Ann-Margaret Navarra
1,*,
Taehoon Ha
2,
Eva Liang
1,
Maurade Gormley
3,
David R. Garcia
4,
Jason Fletcher
5,
Lloyd A. Goldsamt
5,
Michael G. Rosenberg
6,
Karin Hasegawa
7 and
Jie Yang
8
1
School of Nursing, Stony Brook University, Stony Brook, NY 11794, USA
2
Biostatistical Consulting Core, School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
3
School of Nursing, University of Connecticut, Storrs, CT 06268, USA
4
School of Nursing, University of Texas Rio Grande Valley, Rio Grande, TX 78582, USA
5
Rory Meyers College of Nursing, New York University, New York, NY 10016, USA
6
Division of Infectious Diseases, Department of Pediatrics, Jacobi Medical Center, Bronx, NY 10461, USA
7
Department of Applied Mathematics and Statistics, School of Engineering, Stony Brook University, Stony Brook, NY 11794, USA
8
Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2025, 10(12), 332; https://doi.org/10.3390/tropicalmed10120332
Submission received: 15 August 2025 / Revised: 31 October 2025 / Accepted: 4 November 2025 / Published: 25 November 2025
(This article belongs to the Special Issue Adolescent HIV Care and Transition Strategies: Challenges, Outcomes, and Interventions)
Versions Notes

Abstract

Antiretroviral therapy (ART) adherence behavior is heterogeneous among adolescents and young adults (AYAs) with HIV and influenced by individual and interpersonal psychosocial factors. The primary objective of this study is to characterize ART adherence phenotypes and psychosocial symptom clusters, as related to ART adherence and HIV viral load suppression. This analysis included 60 AYAs with HIV enrolled in an ART adherence support clinical trial. Self-reported ART adherence at baseline, 12-weeks, and 24-weeks was used to define four ART adherence phenotypes: consistently high adherence (YY), early-only adherence (YN), late-only adherence (NY), and consistently low adherence (NN). Symptom clusters were empirically derived from baseline psychosocial measures, including adherence self-efficacy, ART knowledge, HIV stigma, psychological distress (depression, anxiety, trauma), and social support. Linear mixed-effects models were used to examine psychosocial symptom outcomes at three timepoints (baseline, 12-weeks, and 24-weeks) and across groups with different adherence or viral load phenotypes. Using hierarchical clustering, four distinct clusters were identified, underscoring heterogeneity of psychosocial symptoms and patterns of ART and viral suppression. Findings from this analysis are among the first known characterizations of ART adherence phenotypes and psychosocial symptom clusters among AYAs with HIV. Heterogeneity in clusters underscores the need to examine other factors, such as resilience, not captured in the present study. Overall, these study findings contribute to improved understanding of the multi-level psychosocial influences of ART adherence and viral load suppression.
Keywords: HIV; phenotype; symptom cluster(s); chronic illness; self-management; adolescence; young adulthood HIV; phenotype; symptom cluster(s); chronic illness; self-management; adolescence; young adulthood

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MDPI and ACS Style

Navarra, A.-M.; Ha, T.; Liang, E.; Gormley, M.; Garcia, D.R.; Fletcher, J.; Goldsamt, L.A.; Rosenberg, M.G.; Hasegawa, K.; Yang, J. Characterization of Antiretroviral Therapy (ART) Adherence Phenotypes and Psychosocial Symptom Clusters Among Black/African American (AA) and Hispanic/Latine Adolescents and Young Adults (AYAs) with HIV in the Adherence Connection for Counseling, Education, and Support (ACCESS-II) Trial. Trop. Med. Infect. Dis. 2025, 10, 332. https://doi.org/10.3390/tropicalmed10120332

AMA Style

Navarra A-M, Ha T, Liang E, Gormley M, Garcia DR, Fletcher J, Goldsamt LA, Rosenberg MG, Hasegawa K, Yang J. Characterization of Antiretroviral Therapy (ART) Adherence Phenotypes and Psychosocial Symptom Clusters Among Black/African American (AA) and Hispanic/Latine Adolescents and Young Adults (AYAs) with HIV in the Adherence Connection for Counseling, Education, and Support (ACCESS-II) Trial. Tropical Medicine and Infectious Disease. 2025; 10(12):332. https://doi.org/10.3390/tropicalmed10120332

Chicago/Turabian Style

Navarra, Ann-Margaret, Taehoon Ha, Eva Liang, Maurade Gormley, David R. Garcia, Jason Fletcher, Lloyd A. Goldsamt, Michael G. Rosenberg, Karin Hasegawa, and Jie Yang. 2025. "Characterization of Antiretroviral Therapy (ART) Adherence Phenotypes and Psychosocial Symptom Clusters Among Black/African American (AA) and Hispanic/Latine Adolescents and Young Adults (AYAs) with HIV in the Adherence Connection for Counseling, Education, and Support (ACCESS-II) Trial" Tropical Medicine and Infectious Disease 10, no. 12: 332. https://doi.org/10.3390/tropicalmed10120332

APA Style

Navarra, A.-M., Ha, T., Liang, E., Gormley, M., Garcia, D. R., Fletcher, J., Goldsamt, L. A., Rosenberg, M. G., Hasegawa, K., & Yang, J. (2025). Characterization of Antiretroviral Therapy (ART) Adherence Phenotypes and Psychosocial Symptom Clusters Among Black/African American (AA) and Hispanic/Latine Adolescents and Young Adults (AYAs) with HIV in the Adherence Connection for Counseling, Education, and Support (ACCESS-II) Trial. Tropical Medicine and Infectious Disease, 10(12), 332. https://doi.org/10.3390/tropicalmed10120332

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