Adherence to antiretroviral therapy in rural persons living with HIV disease in the United States

Abstract

The current study delineated patterns and predictors of adherence to antiretroviral therapy in 329 persons living with HIV disease in rural areas of 12 US states. Participants provided self-report data on patterns of HIV medication adherence, reasons for missing medication doses, psychological symptomatology, life-stressor burden, social support, ways of coping, coping self-efficacy, the quality of their relationship with their main physician, and barriers to health care and social services. Based on adherence data collected via retrospective, self-report assessment instruments, only 50% of participants adhered consistently to antiretroviral therapy regimens in the past week. Consistent adherence was more common in White participants, persons who had progressed to AIDS, and 'native infections' (i.e. persons who were born, raised, and infected in their current place of residence). Logistic regression analyses indicated that consistent adherence was reported by persons who drank less alcohol, had a good relationship with their main physician, and engaged in more active coping in response to HIV-related life stressors. As the number of rural persons living with HIV disease continues to increase, research that identifies correlates of non-adherence and conceptualizes approaches to optimize adherence in this group is urgently needed.

Impact of HIV-Related Stigma on Health Behaviors and Psychological Adjustment Among HIV-Positive Men and Women

“…Medication adherence-Medication adherence was assessed using four-items adapted from previously validated measures (Catz, Kelly, Bogart, Benotsch, & McAuliffe, 2000;Chesney et al, 2000). Adherence difficulties were assessed based on a seven day recall period, consistent with other published reports (e.g., Heckman, Catz, Heckman, Miller, & Kalichman, 2004;Wilson, Tchetgen, & Spiegelman, 2001). Prior research confirms that a seven day assessment interval provides a valid estimate of adherence that correlates with electronic (MEMS) monitoring data and is predictive of viral load (Arnsten et al, 2001).…”

Asociación entre los niveles de estrés y depresión y la adhesión al tratamiento en personas seropositivas al VIH en Hermosillo, México

“…Las personas seropositivas al VIH que participaron en el presente estudio presentaron puntuaciones promedio intermedias en las preguntas relacionadas con el estrés y puntuaciones bajas en las relacionadas con la depresión, lo que indica que, en términos generales, este grupo de personas se ha ajustado favorablemente a su condición y a su tratamiento (22)(23)(24).…”

HIV Care Providers' Implementation of Routine Alcohol Reduction Support for Their Patients

“…[8][9][10] While not all studies examining the relationship between alcohol use and medication adherence have found a negative association between the two, 11 some studies have determined that people consuming alcohol while undergoing ARV treatment prescribed are considerably less likely to be adherent to the medication. [12][13][14] Of especially great concern is the high prevalence of coinfection of HIV and hepatitis C virus (HCV), with the consequence that end-stage liver disease, accelerated as a result of alcohol use among those coinfected, has become a leading cause of illness and death among these individuals. 15,16 Furthermore, HCV treatment is less effective in people with HIV=HCV coinfection, and its effectiveness is limited even more by ongoing alcohol use.…”