Factors Associated With Adherence to Antiretroviral Therapy

Abstract

The purpose of this study was to examine the relationship of sociodemographic characteristics, patient perceptions, and patient characteristics including spirituality, self-reported adherence, and highly active antiretroviral therapy. The convenience sample consisted of 120 English-speaking adults (60% male, 35% female, 5% transgendered) with HIV/AIDS from two HIV service agencies in a large metropolitan city in the southeastern United States. The mean self-reported adherence was 83.1% (SD = 15.7%). Adherence was significantly correlated with perceived support and absence of barriers, strong intentions to adhere, perceived effectiveness of the medications, higher levels of perceived general health, fewer years of HIV disease, and fewer years on antiretroviral medications. Existential well-being (e.g., viewing life as positive and having meaning) was a weak significant correlate. Backward regression analysis was conducted to identify a parsimonious model of predictors of adherence. The final model included presence of support and absence of barriers, fewer years of HIV infection, no current alcohol use, perceived severity of HIV, existential well-being, and male gender. This model explained 19.4% of the variance in adherence (observed F[6, 100] = 5.6, p < .0001).

Gaps in the Continuum of HIV Care: Long Pretreatment Waiting Time between HIV Diagnosis and Antiretroviral Therapy Initiation Leads to Poor Treatment Adherence and Outcomes

“…Furthermore, during the pretreatment period, HIV-positive patients with high CD4 counts may regard themselves as the health and neglect medical advice [26]. In contrast, patients who have received correct knowledge about ART and would initiate therapy earlier after diagnosis would be more adaptable to adhere to it [27]. This hypothesis is consistent with our results that follow-up status of the long waiting treatment population is not ideal.…”

Common mental health problems and antiretroviral therapy adherence

“…The expression of concern and encouragement from friends and family regarding the patient's engagement in health promoting behaviours, including medication adherence, may combine with the patient's social desirability needs to yield higher rates of ART adherence. Positive social support, including being married, appears to be strongly associated with adherence to ART (e.g., Holstad, Pace, De, & Ura, 2006;Parruti et al, 2006). Conversely, it has been shown that a disruption in positive social support such as family conflict, the end of an intimate relationship, or the death of a spouse may cause some patients to question the need to adhere to their medication (Wood, Tobias, & McCree, 2004).…”

Women and Vulnerability to HAART Non-Adherence: A Literature Review of Treatment Adherence by Gender from 2000 to 2011

“…In the post-HAART (highly active antiretroviral therapy) era (2000), adherence is considered more potent and manageable due to drug regimens with more convenient dosing schedules and improved side-effect profiles. However, subpopulations of individuals, including injection drug users (IDUs) not using methadone [3,4], individuals using crack or cocaine, and problematically using alcohol [5][6][7][8], individuals with depression [9•, 10-15], and women [7, 8, 16, 17••], have been identified as less likely to maintain an adequate rate of adherence to maintain virological suppression. Among those with poor adherence, factors such as perceived stigma [18,19], stress [20,21], trauma [12,22], and lack of social support [7,15,21,23] have been shown to have a negative impact on adherence.…”