Predictors of Antiretroviral Adherence Self-efficacy Among People Living With HIV/AIDS in a Canadian Setting

Lee, William K; Milloy, M.‐J.; Nosova, Ekaterina; Walsh, John

doi:10.1097/qai.0000000000001878

Cited by 13 publications

(7 citation statements)

References 54 publications

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“…According to Fisher’s study,10 behavioural skills for adherence to antiretroviral therapy include a sense of self-efficacy and an objective ability to use skills to improve adherence. Previous research indicates that increased self-efficacy in the use of antiretroviral drugs predicted better medication adherence 26. The combination of education and skills development with group training activities is expected to improve adherence among PLHIV with low self-efficacy.…”

Section: Discussionmentioning

confidence: 99%

A model to predict adherence to antiretroviral therapy among people living with HIV

Chen

Long

et al. 2021

Sex Transm Infect

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ObjectivesSuboptimal adherence to antiretroviral therapy (ART) dramatically hampers the achievement of the UNAIDS HIV treatment targets. This study aimed to develop a theory-informed predictive model for ART adherence based on data from Chinese.MethodsA cross-sectional study was conducted in Shenzhen, China, in December 2020. Participants were recruited through snowball sampling, completing a survey that included sociodemographic characteristics, HIV clinical information, Information-Motivation-Behavioural Skills (IMB) constructs and adherence to ART. CD4 counts and HIV viral load were extracted from medical records. A model to predict ART adherence was developed from a multivariable logistic regression with significant predictors selected by Least Absolute Shrinkage and Selection Operator (LASSO) regression. To evaluate the performance of the model, we tested the discriminatory capacity using the concordance index (C-index) and calibration accuracy using the Hosmer and Lemeshow test.ResultsThe average age of the 651 people living with HIV (PLHIV) in the training group was 34.1±8.4 years, with 20.1% reporting suboptimal adherence. The mean age of the 276 PLHIV in the validation group was 33.9±8.2 years, and the prevalence of poor adherence was 22.1%. The suboptimal adherence model incorporates five predictors: education level, alcohol use, side effects, objective abilities and self-efficacy. Constructed by those predictors, the model showed a C-index of 0.739 (95% CI 0.703 to 0.772) in internal validation, which was confirmed be 0.717 via bootstrapping validation and remained modest in temporal validation (C-index 0.676). The calibration capacity was acceptable both in the training and in the validation groups (p>0.05).ConclusionsOur model accurately estimates ART adherence behaviours. The prediction tool can help identify individuals at greater risk for poor adherence and guide tailored interventions to optimise adherence.

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Section: Discussionmentioning

confidence: 99%

A model to predict adherence to antiretroviral therapy among people living with HIV

Chen

Long

et al. 2021

Sex Transm Infect

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“…Penelitian Lee (2020) menerangkan masalah psikologis yang dialami oleh pasien dengan HIV dan AIDS salah satunya adalah tingkat self-efficacy yang rendah (Lee, 2020). Hal ini disebabkan karena ODHA perlu beradaptasi kembali dengan kondisi tubuh dan lingkungannya setelah teridentifikasi positif HIV, yang menyebabkan keyakinan diri pada ODHA akan menurun.…”

Section: Self-efficacy Responden Pasien Hiv Dan Aids DI Puskesmas Kut...unclassified

Hubungan Tingkat Spiritualitas dengan Self-Efficacy pada Pasien HIV/AIDS di Puskesmas Kuta II

Indrayana¹,

Arisudhana²,

Putra³

2023

Journal NURSEPEDIA

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Latar Belakang: Orang dengan HIV dan AIDS (ODHA) yang baru positif HIV di tahun pertama lebih rentan mengalami gangguan psikologis. Dampak dari respon emosional yang negatif dapat menimbulkan penurunan self-efficacy. Self-efficacy dapat dipengaruhi oleh faktor budaya. Self-efficacy dipengaruhi faktor budaya melalui kepercayaan. Kepercayaan akan hubungan individu dengan Tuhan, lingkungan dan sesama merupakan pengertian dari spiritualitas. Spiritualitas terdiri atas dua dimensi yaitu: sikap spiritual dan kemampuan spiritual, dimana kemampuan spiritual memiliki peran yang paling efektif dalam meningkatkan self-efficacy. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan tingkat spiritualitas dengan self-efficacy pada pasien HIV dan AIDS di Puskesmas Kuta II. Metode: Penelitian ini merupakan penelitian kuantitatif dengan metode deskriptif korelasional dengan pendekatan cross-sectional, dan penilaian untuk tingkat spiritualitas menggunakan kuesioner Daily Spiritual Experience Scale (DSES) serta untuk pengukuran self-efficacy menggunakan kuesioner General Self-Efficacy (GSE). Teknik sampling yang dilakukan menggunakan non-probability sampling yaitu purposive sampling dengan jumlah sampel sebanyak 73 orang. Hasil: Hasil penelitian ini menunjukan hasil uji hipotesis menggunakan Pearson Product Moment mendapatkan nilai p-value = 0,000 atau p-value < 0,05. Kesimpulan: Terdapat hubungan tingkat spiritualitas dengan self-efficacy pada pasien HIV dan AIDS di Puskesmas Kuta II. Disarankan kepada pasien dan keluarga agar tetap memperhatikan tingkat spiritalitas dan self-efficacy dalam mengatasi permasalahan dalam kehidupan.

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“…Adherence to ART is associated with multiple behavioral, social, and clinical factors. [4][5][6][7] However, identifying and addressing all factors potentially contributing to suboptimal ART adherence in individual patients can be challenging for healthcare providers during brief clinic visits. 8 Screening assessments using patient-reported outcomes assessments (PROs) in routine HIV care can improve patient-provider communication and focus provider attention on symptoms or behaviors that may not otherwise be addressed, such as mental health issues and substance use.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Suboptimal Adherence Identified by Patient-Reported Outcomes Assessments in Routine HIV Care at 2 North American Clinics

Short¹,

Wang²,

Suri³

et al. 2022

PPA

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Use of patient-reported outcomes assessments (PROs) can improve patient-provider communication and focus provider attention on current health issues. This analysis examines the association between suboptimal antiretroviral therapy (ART) adherence and factors obtained through PROs among people with HIV (PWH) at 2 North American outpatient clinics. Patients and Methods: Immediately before a clinic visit, PWH completed self-administered PROs. Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from logistic regression models to identify sociodemographic and health-related factors (satisfaction with ART, difficulty meeting housing costs, depression, intimate partner violence, risk of malnutrition, smoking status, alcohol use, and substance use) associated with suboptimal adherence (defined as self-reporting <95% or <80% adherence). Multiple imputation was performed to account for missing data in the multivariate analyses. Results: Of 1632 PWH, 1239 (76%) responded to the adherence assessment; of these, 268 (22%) and 106 (9%) reported <95% and <80% adherence, respectively. Of 1580 PWH who responded, 354 (22%) were dissatisfied with their HIV medication. Of responding PWH, 19% reported moderate-to-severe depression, 23% indicated they were at risk of malnutrition, 34% were current smokers, and 62% reported substance use in the past 3 months. Dissatisfaction with ART was significantly associated with <95% and <80% adherence in the unadjusted analysis (unadjusted OR [95% CI], 3.38 [2.51-4.56] and 4.26 [2.82-6.42], respectively) and adjusted analysis (adjusted OR [95% CI], 2. 76 [1.91-4.00] and 3.28 [1.95-5.52], respectively); significance remained after multiple imputation. In adjusted analyses, no risk of malnutrition was significantly associated with reduced odds of <95% adherence after multiple imputation (adjusted OR [95% CI], 0.714 [0.511-0.997]); no other factors were associated with <95% or <80% adherence. Conclusion: These results suggest that implementation of PROs evaluating treatment satisfaction may provide value to adherence management in routine HIV care.

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Predictors of Antiretroviral Adherence Self-efficacy Among People Living With HIV/AIDS in a Canadian Setting

Cited by 13 publications

References 54 publications

A model to predict adherence to antiretroviral therapy among people living with HIV

A model to predict adherence to antiretroviral therapy among people living with HIV

Hubungan Tingkat Spiritualitas dengan Self-Efficacy pada Pasien HIV/AIDS di Puskesmas Kuta II

Risk Factors for Suboptimal Adherence Identified by Patient-Reported Outcomes Assessments in Routine HIV Care at 2 North American Clinics

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