Three types of self-efficacy associated with medication adherence in patients with co-occurring HIV and substance use disorders, but only when mood disorders are present

Abstract

BackgroundAdherence with medication regimens for human immunodeficiency virus (HIV) is a life-saving behavior for people with HIV infection, yet adherence is challenging for many individuals with co-occurring substance use and/or mood disorders. Medication-taking self-efficacy, which is the confidence that one can take one’s medication as prescribed, is associated with better adherence with HIV medication. However, little is known about the influence that other kinds of self-efficacy have on adherence with HIV medication, especially among HIV-infected individuals with co-occurring substance use and/or mood disorders. We sought to examine the relationship between adherence with HIV medication among substance users and three specific kinds of self-efficacy, ie, one’s confidence that one can communicate with medical providers, get support, and manage one’s mood. We further sought to examine whether symptoms of depression and anxiety moderate these relationships.MethodsPatients were recruited from three HIV clinics in the southeastern United States as part of an integrated study of treatment for HIV and substance use.ResultsWe interviewed 154 patients with HIV and substance use who reported taking HIV medications. Based on symptoms of depression and anxiety using the Patient Health Questionnaire-9 and the Hospital Anxiety and Depression Scale-Anxiety, 63% had probable depression and/or anxiety. Higher levels of self-efficacy in provider communication (β = 3.86, P < 0.01), getting needed support (β = 2.82, P < 0.01), and mood management (β = 2.29, P < 0.05) were related to better self-reported adherence with HIV medication among study participants with probable depression and/or anxiety. The three kinds of self-efficacy were not associated with medication adherence among participants with HIV and substance use only.ConclusionIn the search for mutable factors to improve medication adherence among individuals triply diagnosed with HIV, substance use, and mood disorders, these findings support previous research indicating the benefit of enhancing self-efficacy, and further point to three specific kinds of self-efficacy that may benefit medication adherence, ie, provider communication, getting support, and mood management.

Prevalence and correlates of depression and anxiety among patients with HIV on-follow up at Alert Hospital, Addis Ababa, Ethiopia

“…This outcome was consistent by the studies done in Ethiopia and South Africa that were stigma was associated with anxiety [27, 30]. …”

“…Additionally, our findings was higher than the studies done in Ethiopia at Debrebirhan hospital, Ghana, Thailand, Brazil and Asia, in which the prevalence were reported to be 22.2, 7.2, 16.3, 12.6, 20.3 % respectively [30, 37, 45, 46, 19]. The above prevalence variations might be due to the difference in sample size used and different measurement tools used to assess anxiety.…”

“…Being female had 3 times to develop anxiety as compared to male that was similar to the studies done in Ethiopia and Ghana [30, 35]. Being female is the exposure of acute life experience, low social interaction and had less social support from friends and families might be increased risk of anxiety [30, 35].…”

“…In this study, being divorce was 2.5 times risk of developing anxiety as compared to married. This study was supported study done at Debretabor hospital in Ethiopia that was one of the outcome of divorce was affects the whole family structure and which leads to low self-confidence and financial problem [30]. …”

“…Being female is the exposure of acute life experience, low social interaction and had less social support from friends and families might be increased risk of anxiety [30, 35]. …”