Situational Temptation for HIV Medication Adherence in High-Risk Youth

Abstract

This study explored the role of situational temptation, a component of self-efficacy, in adolescent and young adult (ages 16-24) HIV medication adherence by assessing participants' perceptions of their temptation to miss medications in various situations (e.g., when medication causes physical side effects, when there is fear of disclosure of HIV status). Youth (n ¼ 186; 83% African American) were participants in a multisite clinical trial examining the efficacy of a motivational intervention. Data were collected using computer-assisted personal interviewing. Youth believed the most tempting reasons or situations that might lead them to miss their HIV medications to be symptoms (if the medicine caused you to have other physical symptoms) and sick (if the medicine made you sick to your stomach or made you throw up or if it tasted bad), but these were not significantly associated with nonadherence. This suggests disconnection between youths' expectations of temptation and actual tempting situations associated with nonadherence. Situational temptations associated with nonadherence included lack of social support, needing a break from medications, and not seeing a need for medications. Interventions to improve adherence should consider perceptions of HIV medications, particularly the benefits of taking medications and expectations of physical symptoms. Interventionists and clinicians should consider situations that may tempt youth to miss doses of medication and help youth gain insight into these temptations. Emerging methods, such as Ecological Momentary Assessment (e.g., daily diaries, cell phone text messaging), may be useful in gaining insight into the day-to-day experience of youth living with HIV.

Computerized intervention to increase motivation for diabetes self-management in adolescents with type 1 diabetes

“…These rates suggest delivering a computer intervention at the time of diabetes clinic visits is a feasible, acceptable strategy. This is a promising finding given the high drop-out rates observed when brief motivational interventions have been delivered by human interventionists outside of routine medical appointments (Naar-King et al, 2010; MacDonell et al, 2011). …”

An Exploration of Syndemic Factors That Influence Engagement in HIV Care Among Black Men

“…P. Giordano, Hartman, Gifford, Backus, & Morgan, 2009). Engagement in care and adherence to antiretrovirals are associated with numerous factors including exposure to community violence (Quinn, Voisin, Bouris, & Schneider, 2016), lack of social support (MacDonell, Naar-King, Murphy, Parsons, & Huszti, 2011), low self-efficacy (Naar-King et al, 2006), and depression and anxiety (Reisner et al, 2009). There is also strong evidence that HIV stigma contributes to poor medication adherence (Quinn et al, 2017) by reducing self-efficacy for adherence and self-care and raising concerns about inadvertent disclosure of HIV status (Sweeney & Vanable, 2016).…”

A Longitudinal Analysis of Antiretroviral Adherence Among Young Black Men Who Have Sex With Men

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