Adherence of Human Immunodeficiency Virus–Infected Patients to Antiretroviral Therapy

Abstract

The impact of demographic, psychosocial, and medical regimen-related variables on adherence of 123 human immunodeficiency virus (HIV)-infected patients to antiretroviral therapy was assessed by means of refill methodology. Satisfaction with social support (P = .029), problem-focused coping (P = .027), and active-behavioral coping (P = .011) correlated significantly with adherence, whereas loss of motivation (P = .006), hopelessness (P = .16), and avoidant coping (p = .015) correlated with nonadherence. At the 6-month follow-up, the mean CD4 cell count differed significantly among adherent versus nonadherent patients (a mean increase of 78/mm3 vs. a mean decrease of 5/mm3; P = .018). Adherence did not correlate with the number of antiretroviral medications consumed per day (mean, 3.0 vs. 2.5). Non-Caucasian patients were more likely to be nonadherent than Caucasian patients (relative risk, 2.5; 95% confidence interval, 1.2-5.3; P = .013); this difference was not explained by age, education, employment, income, history of intravenous drug use, or medical regimen. Non-Caucasian patients, however, were less satisfied with their social support (P = .04) and informational support (P = .016) and were more likely to utilize emotion-focused coping (P = .01). Thus, satisfaction with social support and coping style significantly impacted adherence and likely accounted for the observed racial difference in adherence among HIV-infected patients.

Intentionality of medication non-adherence among individuals living with HIV/AIDS in Hong Kong

“…The finding that avoidant coping is associated with intentional nonadherence is in line with previous literature (Halkitis, Parsons, Wolitski, & Remien, 2003;Singh et al, 1999;Weaver et al, 2005). Individuals who use avoidant coping strategies may choose to escape the stressors when dealing with the disease and therefore, be less likely to take an active role in their medication management.…”

Fatores de risco para a não adesão ao tratamento com terapia antiretroviral altamente eficaz

“…Researchers verified that the non-Caucasian patients were significantly more non-compliant than Caucasian patients (16) . In another study, the authors showed that there was a relative risk of 1.7 regarding non-white ethnicity (8) .…”

Health Systems and Access to Antiretroviral Drugs for HIV in Southern Africa: Service Delivery and Human Resources Challenges

“…Breakthrough drug resistance, followed by rising viral loads and clinical failure is relatively common, even with high levels of adherence. 16 This entails ongoing clinical and laboratory monitoring and access to second-line regimens. Side-effects of drugs, especially in the early period of treatment, occur relatively frequently, some of which are sufficiently dangerous to require modifications to treatment.…”