Psychological model of ART adherence behaviors in persons living with HIV/AIDS in Mexico: a structural equation analysis

Abstract

OBJECTIVE The objective of this study has been to test the ability of variables of a psychological model to predict antiretroviral therapy medication adherence behavior.METHODS We have conducted a cross-sectional study among 172 persons living with HIV/AIDS (PLWHA), who completed four self-administered assessments: 1) the Psychological Variables and Adherence Behaviors Questionnaire, 2) the Stress-Related Situation Scale to assess the variable of Personality, 3) The Zung Depression Scale, and 4) the Duke-UNC Functional Social Support Questionnaire. Structural equation modeling was used to construct a model to predict medication adherence behaviors.RESULTS Out of all the participants, 141 (82%) have been considered 100% adherent to antiretroviral therapy. Structural equation modeling has confirmed the direct effect that personality (decision-making and tolerance of frustration) has on motives to behave, or act accordingly, which was in turn directly related to medication adherence behaviors. In addition, these behaviors have had a direct and significant effect on viral load, as well as an indirect effect on CD4 cell count. The final model demonstrates the congruence between theory and data (x 2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance.CONCLUSIONS The results of this study support our theoretical model as a conceptual framework for the prediction of medication adherence behaviors in persons living with HIV/AIDS. Implications for designing, implementing, and evaluating intervention programs based on the model are to be discussed.

Resilience and HIV: a review of the definition and study of resilience

“…In some of these studies, social support was associated with clinic attendance (Waldrop-Valverde, Guo, Ownby, Rodriguez, & Jones, 2014) and delayed time to care (McCoy et al, 2009). In other studies, there were no significant relationships of social support with ART adherence (Sagarduy, Lopez, Remirez, & Davila, 2017), entry into care (Williams, Shahryarinejad, Andrews, & Alcabes, 1997), viral load or ART adherence (Attonito, Devieux, Lerner, Hospital, & Rosenberg, 2014;Safren et al, 2014). However, in the Friedman et al (2017) study, social support was associated negatively with viral load and in the work of Leserman et al (2002), less social support predicted HIV disease progression.…”

Analysis of compliance to antiretroviral treatment among patients with HIV/AIDS

“…Sagarduy et al (23) argue that factors of the patient's personality, such as decision-making and tolerance of frustration, are directly related to compliance to antiretroviral therapy. For Betencur et al (19) , psychoeducation can be used to address negative beliefs regarding treatment and to screen for symptoms of anxiety and depression.…”

Socio-Demographic, Economic and Clinical predictors of HAART Adherence Competence for HIV Positive adults at Felege Hiwot Teaching and Specialized Hospital, North West Ethiopia

“…It is the time period an individual to visit the hospital to re-fill the pills for the next months. Thus, it is said that a person is HAART adherence competent when he/she uses those resources to do what is expected, as would be the case in consuming medication as prescribed [26]. Retention in HIV medication care is a crucial activity and furthermore, HAART adherence competence is a primary need for achieving long term survival with HIV infection [27].…”