Social-cognitive correlates of antiretroviral therapy adherence among HIV-infected individuals receiving infectious disease care in a medium-sized northeastern US city

Dados Bibliográficos

ID19441012
AutoresJennifer L Brown (0000-0002-6683-0053, autor correspondente), Rae A Littlewood (Mind Research Network), Peter A Vanable (Syracuse University)
Ano2013
Volume25
Fascículo9
Páginas1149-1158
Data de publicação2013-09-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoAIDS Care (JOURNAL)
Identificadores do periódicoISSN: 0954-0121 • E-ISSN: 1360-0451
EditoraInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2012.752566
PMID23311323
PMCIDPMC3626750
OpenAlexW2014982364
IdiomaEN
Citações recebidas17
Referências citadas44

High levels of antiretroviral therapy (ART) adherence are required to achieve optimal viral suppression. To better understand mechanisms associated with ART adherence, this study characterized demographic and social-cognitive correlates of ART adherence among HIV-infected individuals from a medium-sized northeastern US city (n=116; 42% female; 43% African-American). Participants completed an audio computer-assisted self-interviewing survey assessing demographics, social-cognitive constructs, and ART adherence, and the participants' most recent viral load was obtained from their medical charts. Suboptimal ART adherence (taking less than 95% of prescribed medications during the past month) was reported by 39% of participants and was associated with being female, being a minority, and having a detectable viral load. In a hierarchical logistic regression analysis, greater than 95% ART adherence was associated with higher levels of adherence self-efficacy (AOR =1.1; p=0.015), higher perceived normative beliefs about the importance of ART adherence (AOR=1.3; p=0.03), and lower concern about missing ART doses (AOR=0.63; p=0.002). Adherence did not differ based on ART outcome expectancies, ART attitudes, or the perceived necessity of ART. In fact, most participants endorsed positive attitudes and expectancies regarding the need for and effectiveness of ART. Taken together, results indicate that suboptimal adherence remains high among HIV-infected minority women, a subpopulation that experiences particularly high rates of chronic stress due to both illness-specific stressors and broader environmental stressors. Consistent with social-cognitive theory, adherence problems in our sample were linked with deficits in self-efficacy as well as perceived norms and behavioral intentions that do not support a goal of 100% adherence. We suggest that interventions to improve adherence informed by social-cognitive theory (1) target patients who are at risk for adherence problems, (2) provide a supportive environment that promotes high rates of adherence, and (3) address inaccurate beliefs regarding optimal adherence levels

Antiretroviral therapy · Cognition · Family medicine · Logistic regression · Multilevel model · Normative · Psychiatry · Social cognitive theory · Stressor · Viral load · Adolescent Sexual and Reproductive Health · Clinical Psychology · HIV Research and Treatment · HIV/AIDS Research and Interventions · Medicine · Psychology · Social Psychology · Internal Medicine