HIV patient insight on adhering to medication: a qualitative analysis

Abstract

Research on HIV medication adherence has relied mainly on quantitative methods. The objective of this study was to explore factors associated with adherence from the HIV-infected patient's perspective. Six focus groups were convened with treatment-experienced HIV-positive individuals. The discussions focused on issues that make it easy or difficult to adhere to HIV regimens. Thirty-five patients participated in the focus groups, which were conducted in Washington, D.C., and Los Angeles. The mean age was 48; 66% were male; 63% were black; and 40% contracted HIV through heterosexual contact. Six major themes emerged from the data that influenced adherence to medication: regimen complexity/medication features (including number of pills), lifestyle fit, emotional impacts (including worry, anger, stress and anxiety), side effects, medication effectiveness, and communication (including information from friends, physicians, and published sources). The data informed a conceptual framework, illustrating the possible interactions among these themes that can potentially be used by clinicians when discussing HIV treatment options with patients. This is potentially one of the first focus group studies concentrating on HIV medication adherence. The findings highlight specific factors that should be considered when trying to improve adherence and may be helpful in clinical decision-making.

Cannabis use and HIV antiretroviral therapy adherence and HIV-related symptoms

“…Consistent with the HIV treatment adherence literature, we posited that non-cannabis using individuals would experience negative effects of HIV symptoms, including ART side effects, and that these symptoms would contribute to decreased treatment adherence (Beusterien et al, 2008). This prediction was primarily based on the results of recent work, among mostly non-cannabis using HIV populations, showing generally poor adherence to HIV treatment (Chesney 2003;Solomon and Halkitis 2008).…”

“…Studies that have assessed adherence rates among individuals with HIV have found that between 14 and 35 % of individuals with HIV have trouble maintaining at least 80 % adherence to ART (Chesney 2003;Solomon & Halkitis, 2008), with viral suppression not achieved among 30-70 % of HIV positive individuals (Paterson et al, 2000;Low-Beer et al, 2000). The primary contributors to poor adherence among individuals with HIV include medication side effects (e.g., nausea), regimen complexity (e.g., number of pills), substance use (French et al, 2011;Friedman et al, 2009), and emotional factors (e.g., anxiety, depression) (Beusterien et al, 2008;Parienti et al, 2009).…”

The Role of ARV Associated Adverse Drug Reactions in Influencing Adherence Among HIV-Infected Individuals: A Systematic Review and Qualitative Meta-Synthesis

“…Thirty-three out of 39 studies reported that perceived adverse ARV reactions decreased adherence [12, 15–46], whilst six studies [47–52] described no apparent relationship. Nineteen studies [12, 15–27, 29, 32, 36, 44, 47] were conducted in high-income countries, eight [30, 31, 33, 34, 41, 42, 46, 49] in middle-income countries, and twelve [28, 35, 37–40, 43, 45, 48, 50–52] in low-income countries. (Countries—see Tables 1, 2).…”

The Social and Health Problems of People Living with HIV/AIDS in Izmir, Turkey

“…Valuable data, especially in the qualitative section, were obtained in this study. Beusterien et al reported that focus groups were a valuable qualitative method for studying issues in socially marginalized groups [12].…”