Resilience and ART Adherence Among a Sample of Racially and Ethnically Diverse Sexual Minority Men With HIV

While racial disparities in HIV antiretroviral treatment (ART) adherence and viral suppression among sexual minority men (SMM) with HIV persist, resilience may serve as an important protective factor. There is, however, a dearth of research exploring the longitudinal associations between resilience and ART adherence among this group. As such, the current study examined prospective associations, including the between- and within-person effects, between resilience and ART adherence among racially diverse SMM with HIV. Data were drawn from Thrive With Me (TWM), a randomized controlled trial of an mHealth intervention targeting ART adherence among SMM. Generalized estimating equations (GEEs) models examined longitudinal associations, including between- and within-person effects, between resilience scores and self-reported 30-day ART adherence, dichotomized as optimal (≥ 90% of doses) versus suboptimal (< 90% of doses) across the 17-month study timeframe, while controlling for covariates. Among 401 SMM with HIV that completed the TWM baseline assessment (M _age = 39.1 years, Standard Deviation = 10.8), 59.9% self-identified as Black/African American. In GEE models, resilience scores were prospectively associated with optimal 30-day ART adherence (b = 0.06, β = 0.38, p < 0.001), at the between-person level, above the effects of covariates. In moderation analyses, resilience scores were associated with optimal ART adherence among Black/African American SMM but not among those identifying as White or another race. These results suggest bolstering resilience may be an important strategy for future interventions aiming to improve ART adherence over time for racially and ethnically diverse SMM with HIV.