Mediators of Social Support and Antiretroviral Adherence Among an Indigent Population in New York City

Abstract

Survey interviews were conducted with a random sample of 50 primarily indigent, African American and Puerto Rican men and women at an outpatient human immunodeficiency virus (HIV) clinic in the Bronx, New York. Analyses revealed a generally high rate of adherence according to self-report data (i.e., on average, participants reported taking 85% of their medications over the last 3 days). However, adherence to the correct number of pills, dosing schedules, and special instructions was more problematic. No sociodemographic or substance use indicators were associated with adherence. Compared to men, women reported higher scores on the Crowne-Marlowe Social Desirability Scale, which were positively correlated with self-reported adherence. "Forgot" (50%) and "felt worse" (46%) were the most common reasons for missed doses. Mediation analyses provided partial support for our proposed model of social support and adherence. Specifically, regression analyses controlling for social desirability indicated that need for social support was positively correlated with acknowledged nonadherence and that this relationship was mediated by self-efficacy and depressive symptomatology.

Loss to follow up from isoniazid preventive therapy among adults attending HIV voluntary counseling and testing sites in Uganda

“…Differences in health care utilization by marital status have been reported previously, 23 and high IPT default rates among the widowed, divorced or separated reported in this study might suggest that people in broken relationships might be less compliant due to a gap in support of close relatives which is fundamental in coping with HIV/AIDS and sustaining compliance. [23][24][25][26] Higher risk in the widowed, separated and divorced group might also be linked to increased household responsibilities which require shouldering workload that could have been shared between two household heads.…”

Mediating roles of medication–taking self-efficacy and depressive symptoms on self-reported medication adherence in persons with HIV: A questionnaire survey

“…Highly active antiretroviral therapy (HAART) has dramatically decreased morbidity and mortality and improved the quality of life in persons with HIV infection; however, these benefits of HAART are dependent upon adherence to medication (Hsu et al, 2001;Simoni et al, 2002). Studies have shown that the optimal adherence rate of 95% for HAART is rare (Lewis and Abell, 2002;Read et al, 2003).…”

“…Studies have shown that the optimal adherence rate of 95% for HAART is rare (Lewis and Abell, 2002;Read et al, 2003). Therefore, researchers have sought to identify factors influencing medication adherence in order to develop interventions to enhance medication adherence (Hsu et al, 2001;Simoni et al, 2002).…”

“…Psychosocial factors such as perceived social support and mood affect medication self-efficacy beliefs in persons with HIV (Simoni et al, 2006;Simoni et al, 2002;Weaver et al, 2005). Perceived supportive relationships and a positive mood increased self-efficacy beliefs (Power et al, 2003;van Servellen and Lombardi, 2005); while decreases in self-efficacy beliefs have been noted due to the moderating effects of the presence of depressive symptoms (Ferguson et al, 2002;Simoni et al, 2006).…”

“…Simoni and colleagues (2006) have evaluated a 3-month social support intervention with 136 persons with HIV. Their conceptual model was derived from their pilot study (n=50) examining mediation effects of affective factors and self-efficacy beliefs between perceived social support and HAART regimen adherence (Simoni et al, 2002). They found that less social support predicted an increased non-clinical level of depression, and higher depression predicted lower medication self-efficacy beliefs.…”