Factors Associated with Suboptimal Antiretroviral Therapy Adherence to Dose, Schedule, and Dietary Instructions

Abstract

The purpose of this study was to assess the degree of suboptimal antiretroviral therapy adherence to dose, schedule, and dietary instructions and to examine the effects of extra-personal, intra-personal, and inter-personal factors on suboptimal adherence across the three types of instructions. Self-report and clinical data were collected from 193 sexually infected Swedish patients receiving ART. Effects of extra-personal, intra-personal, and inter-personal factors on suboptimal adherence were examined using multivariate logistic regression models. Suboptimal adherence to dose instructions was recorded in 12% of patients. Equivalent percentage for suboptimal adherence to schedule instructions was 37% and for suboptimal adherence to dietary instructions 58%. Anxiety was the only risk factor for suboptimal adherence to dose. Heavy pill burden was a risk factor for suboptimal adherence to schedule. Older age and HIV-related post-traumatic stress disorder (PTSD) symptoms decreased the risk of suboptimal adherence to schedule. No factors investigated had an effect on suboptimal adherence to dietary instructions. To improve adherence to dose and schedule instructions, clinicians caring for patients with HIV should assess and treat anxiety and be alert to HIV-related PTSD symptoms.

Assessment of factors associated with the quality of life of patients living with HIV/HCV co-infection

“…Although causal inferences cannot be made, our results suggest that an effective clinical management of psychological symptoms, particularly of depression and anxiety, may improve the functioning and well-being of both co-infected and mono-infected patients. The recognition and effective management of these symptoms are relevant concerns largely because of the negative effects of such symptoms on cART adherence and persistence (Gonzalez et al, 2011;Schönnesson et al, 2007;Springer et al, 2012) and the possible worsening of disease progression (Nanni et al, 2015).…”

The Relationship Between ART Adherence and Smoking Status Among HIV+ Individuals

“…In spite of its importance, studies indicate that high adherence is a significant problem among HIV+ individuals (9–11). Research indicates that many factors are related to adherence including covariates of race, such as discrimination (12, 13), psychiatric diagnoses (14,15) such as depression, alcohol or other drug use (16–18), stress (18,19), social support (20) and coping styles (21). However, there is emerging literature suggesting that tobacco smoking, which is highly prevalent among HIV+ individuals, may also be associated with poor ART adherence (22–26).…”

Viral Suppression and Antiretroviral Medication Adherence Among Alcohol Using HIV-Positive Adults

“…(3, 4) Behavioral research on HIV treatment adherence has identified several factors that reliably predict sub-optimal treatment outcomes from ART, including mood disturbances, poor social support, and impoverished living conditions. (5–8) Another common and robust impediment to medication adherence is alcohol use. (9)…”