Predictors of Medication Adherence Among HIV‐Positive Women in North America

Abstract

Objective Women infected with HIV live with many factors that affect antiretroviral (ARV) medication adherence. Social Action Theory (SAT) explains how context, environment, and psychological factors influence behavior. How these factors are related to HIV adherence in women is unique. The purpose of this analysis was to explore the relationships among contextual, environmental, and regulatory factors with ARV medication adherence in order to assist care providers in improving care for women living with HIV. Design Convenience descriptive multicenter Setting Sixteen HIV clinics and service organizations in North America Participants This sample was drawn from a larger study of 2,182 persons living with HIV recruited from clinics and service from September 2009 to January, 2011. Our study included 383 North American women living with HIV who were taking ARV medications. Methods We assessed the relationship of contextual, environmental, and psychological factors specific to women living with HIV with adherence to ARV medication. Descriptive and multivariate statistics were used to examine the effects of these factors on self-reported ARV adherence. Results Age, depression symptoms, stigma, and engagement with health care provider, and four psychological factors were correlated with self-reported ARV medication adherence (p = .01). Regression analysis indicated that adherence self-efficacy and depression symptoms accounted for 19% for 3-day and 22% for 30-day self-reported medication adherence. Conclusions Adherence self-efficacy and depression symptoms predict ARV medication adherence in women and should be evaluated by nurses. Future research is needed to identify antecedents to and interventions that support adherence self-efficacy and decrease depression symptoms.

The Influence of Psychological Predictors and Cognitive Behavioral Stress Management Intervention on Antiretroviral Therapy (ART) Adherence Among HIV-Positive Female Haitian Alcohol Users

“…However, similar to this current study, another study also found that beliefs about medicines was not related to adherence (Adefolalu et al, 2015) concluding that ART adherence was more closely related to self-efficacy (Tyler-Viola et al, 2014;Adefolalu et al, 2015). When addressing psychological factors, TRA/TPB theory has tended to focus on attitudinal beliefs, self-efficacy, and normative and norm-related beliefs and activities.…”

“…Belief and attitude about illness correlate strongly with treatment adherence in other chronic diseases (Reynolds et al, 2004;Dilorio et al, 2009;Tyler-Viola et al, 2014). According to the health belief model, two major factors influence the likelihood that individuals will adopt recommended regimens: 1) they must feel susceptible to the serious or severe consequences of the disease, and 2) they must believe that the benefits of taking the preventive action outweigh the perceived barriers (Johnson et al, 2006).…”

“…Findings from the studies concluded that facilitators of adherence to HIV care also included the need for supportive family members, (Pyne et al, 2002;Sambisa et al, 2010) desiring emotional support, and instrumental support (Pyne et al, 2002). This is noteworthy, given that researchers have demonstrated that severe life stress is a predictor of early disease progression and poor health outcomes (Dilorio et al, 2009;Tyler-Viola et al, 2014;Sowell & Phillips, 2010;Katz et al, 2013;Ansari & Gaestel, 2010;Li et al, 2011;Pyne et al, 2002;Sambisa, Curtis, & Mishra, 2010).…”

“…Similar to perceived social support and self-efficacy, a high level of belief about the effectiveness of medicine also has a significant correlation with adherence to treatment (Dilorio et al, 2009;Tyler-Viola et al, 2014;Sowell & Phillips, 2010). Studies aimed at identifying the determinants to adherence to ART among HIV patients found that predictors of high adherence were:…”

“…high perception of self-efficacy (Dilorio et al, 2009;Tyler-Viola et al, 2014;Sowell & Phillips, 2010), positive attitude towards taking medication (Dilorio et al, 2009;Horne, Weinman, & Hankins, 1999), not living alone (Ross et al, 1992;McKenzie, 1993) and being a male (Ncama et al, 2008). Further analysis demonstrated that high physician satisfaction, high-perceived social support, and experiencing no side effects were some of the factors related to positive attitude about taking medication.…”