Medication Adherence Mediates the Relationship between Adherence Self-efficacy and Biological Assessments of HIV Health among those with Alcohol Use Disorders

Abstract

The current study examines the relationship between negative consequences of alcohol use, adherence self-efficacy, medication adherence, and biological markers of HIV health (CD4 count and viral load). A total of 275 HIV-positive men and women with alcohol use disorders were surveyed using Audio-CASI measures and time line followback interviews. Findings from a structural equation model suggest that negative consequences related to alcohol use did not directly impact HIV health. Adherence self-efficacy had direct effects on viral load, but not CD4 count. Mediation analyses indicated that self-reported adherence partially mediated the relationship between adherence selfefficacy and viral load. Cognitive-oriented interventions aimed at facilitating adherence self-efficacy may be effective in improving both medication adherence and HIV health. If facilitating confidence improves HIV health, then health care providers can make a strong impact by spending a few short minutes themselves and/or partnering with behavioral health clinicians using techniques like motivational enhancement.

Associação entre uso de álcool em indivíduos com AIDS e adesão ao tratamento antirretroviral: uma revisão da literatura

“…Esse mesmo autor encontrou associação significativa em dois outros artigos publicados em 2007. Em um desses artigos, escrito juntamente com Rosof e Mustanski, Parsons avaliou os subfatores do padrão de uso de álcool e demonstrou que entre os não aderentes é a quantidade de drinks consumidos pelo indivíduo que prediz se haverá ou não falhas na adesão [17][18][19][20][21] .…”

Harmful alcohol drinking among HIV-positive people in Nepal: an overlooked threat to anti-retroviral therapy adherence and health-related quality of life

“…They might have endured poor self-efficacy and not sought appropriate care for opportunistic infections and physical symptoms [39]. Alcohol further increases the risk of the HIV disease progression such as leading to a decrease in CD4 count and an increase in viral load [40].…”

Opinions of a Small Sample of Pharmacists About Pharmacy Setting and Patient Adherence to Antiretroviral Therapy

“…18 In a variety of therapeutic classes, inconsistent adherence is associated with poor clinical outcomes, treatment failure, and increased health care costs. [19][20][21][22][23] In general, patients utilizing specialty community pharmacies receive more personalized care and have better adherence rates compared with those in nonspecialty community pharmacies. 15,[24][25][26][27] A pilot study found that Medi-Cal beneficiaries with HIV who received medication therapy management (MTM) in community pharmacies that specialized in providing HIV-intensive MTM services had higher adherence rates that persisted over 3 years, compared with patients in pharmacies not providing these services.…”