Evidence‐based, multifactorial approach to addressing non‐adherence to antiretroviral therapy and improving standards of care

Abstract

Background: Near-perfect adherence to antiretroviral therapy over time is

The impact of visa status and Medicare eligibility on people diagnosed with HIV in Western Australia: a qualitative report

“…Indeed, health literacy and numeracy may have contributed to the successful medication adherence and persistence seen in this group, together with clinic protocols for adherence monitoring and counselling. 16,17 Only one of the participants expressed concern that generic drugs might not be effective, since he was not experiencing the side-effects that he had when taking a patented combination. This is in contrast with a recent study by Bulsara and colleagues, 18 who found that Western Australians were suspicious of foreign generic manufacturers and sceptical about generic drug bioequivalence.…”

Medication Adherence in HIV-Infected Smokers: The Mediating Role of Depressive Symptoms

“…This study considered the possible mediating role of depressive symptoms. Depression has been related to poorer adherence in several studies with HIV-infected patients (e.g., Herrmann et al, 2008;Horberg et al, 2008;Lazo et al, 2007). Moreover, there is a broad literature documenting the association between smoking and depression in the general population (e.g., Breslau, Kilbey, & Andreski, 1991) and in clinical samples (e.g., Brown, Madden, Palenchar, & Cooper-Patrick, 2000).…”

“…As smoking initiation often occurs in adolescence, it is likely that smoking precedes depression (Wu & Anthony, 1999). Several studies also link depression to adherence difficulties among people living with HIV (Arnsten et al, 2002;Herrmann et al, 2008;Lazo et al, 2007). On the basis of past research linking depression to both elevated risk for smoking and adherence difficulties, we hypothesized that the effect of smoking status on poor adherence may be accounted for depressive symptoms that serve as a common risk factor for both smoking and adherence difficulties.…”

“…HIV-positive patients may not adhere for many reasons, including difficulties associated with regimen complexity, challenges in maintaining medication refills, simple forgetting, and because of the desire to avoid side effects (e.g., Amico et al, 2007;Konkle-Parker, Erlen, & Dubbert, 2008;Oggins, 2003). Adherence can be undermined by psychological factors, including stigma (Vanable, Carey, Blair, & Littlewood, 2006), fear of inadvertent disclosure (Ware, Wyatt, & Tugenberg, 2006), low self-efficacy (Godin, Côté, Naccache, Lambert & Trotter, 2005), perceived stress, and depressive symptoms (Catz et al, 2000;Herrmann et al, 2008). Finally, research suggests that alcohol use (Chander, Lau, & Moore, 1999) and other drug use (e.g., de Jong, Prentiss, McFarland, Machekano, & Israelski, 2005;Gebo, Keruly, & Moore, 2003;Herrmann et al, 2008) can undermine medication adherence.…”

HIV, alcohol, and noninjection drug use

“…In a study of selfreported antiretroviral therapy adherence among 247 HIV-infected adults, poor adherence was significantly associated with alcohol consumption of five or more drinks per occasion (P ¼ 0.008) and use of amphetamines or ecstasy in the past month (P ¼ 0.01). Those with poor medication adherence also had higher perceived stress level and depression score [27].…”