Abstract
Objectives: Adherence to antiretroviral therapy (ART) remains a challenge in efforts to maximize HIV treatment benefits. Previous studies of antiretroviral adherence are limited by low statistical power, homogeneous samples, and biased assessment methods. Based on Social Action Theory and using a large, diverse sample of men and women living with HIV, the objectives of the current study are to clarify correlates of nonadherence to ART and to provide theory-guided, empirically supported direction for intervening on ART nonadherence. Design: Cross-sectional interview study utilizing a computerized interview. Setting: Recruited from clinics, agencies, and via media ads in four U.S. cities from June 2000 to January 2002. Participants: Two thousand seven hundred and sixty-five HIV-positive adults taking ART. Main Outcome Measure: Computer-assessed self-reported antiretroviral adherence. Results: Thirty-two percent reported less than 90% adherence to ART in the prior 3 days. A number of factors were related to nonadherence in univariate analysis. Multivariate analyses identified that being African American, being in a primary relationship, and a history of injection drug use or homelessness in the past year were associated with greater likelihood of nonadherence. Furthermore, adherence self-efficacy, and being able to manage side effects and fit medications into daily routines were protective against nonadherence. Being tired of taking medications was associated with poorer adherence whereas a belief that nonadherence can make the virus stronger was associated with better adherence. Conclusions: Results support the need for multifocused interventions to improve medication adherence that address logistical barriers, substance use, attitudes and expectancies, as well as skills building and self-efficacy enhancement. Further exploration of issues related to adherence for African Americans and men in primary relationships is warranted.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 645-656 |
| Number of pages | 12 |
| Journal | AIDS Patient Care and STDs |
| Volume | 17 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 2003 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Leadership and Management
- Nursing(all)
Cite this
Theory-Guided, Empirically Supported Avenues for Intervention on HIV Medication Nonadherence : Findings from the Healthy Living Project. / Johnson, Mallory O.; Catz, Sheryl L; Remien, Robert H.; Rotheram-Borus, Mary Jane; Morin, Stephen F.; Charlebois, Edwin; Gore-Felton, Cheryl; Goldsten, Rise B.; Wolfe, Hannah; Lightfoot, Marguerita; Chesney, Margaret A.
In: AIDS Patient Care and STDs, Vol. 17, No. 12, 12.2003, p. 645-656.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Theory-Guided, Empirically Supported Avenues for Intervention on HIV Medication Nonadherence
T2 - Findings from the Healthy Living Project
AU - Johnson, Mallory O.
AU - Catz, Sheryl L
AU - Remien, Robert H.
AU - Rotheram-Borus, Mary Jane
AU - Morin, Stephen F.
AU - Charlebois, Edwin
AU - Gore-Felton, Cheryl
AU - Goldsten, Rise B.
AU - Wolfe, Hannah
AU - Lightfoot, Marguerita
AU - Chesney, Margaret A.
PY - 2003/12
Y1 - 2003/12
N2 - Objectives: Adherence to antiretroviral therapy (ART) remains a challenge in efforts to maximize HIV treatment benefits. Previous studies of antiretroviral adherence are limited by low statistical power, homogeneous samples, and biased assessment methods. Based on Social Action Theory and using a large, diverse sample of men and women living with HIV, the objectives of the current study are to clarify correlates of nonadherence to ART and to provide theory-guided, empirically supported direction for intervening on ART nonadherence. Design: Cross-sectional interview study utilizing a computerized interview. Setting: Recruited from clinics, agencies, and via media ads in four U.S. cities from June 2000 to January 2002. Participants: Two thousand seven hundred and sixty-five HIV-positive adults taking ART. Main Outcome Measure: Computer-assessed self-reported antiretroviral adherence. Results: Thirty-two percent reported less than 90% adherence to ART in the prior 3 days. A number of factors were related to nonadherence in univariate analysis. Multivariate analyses identified that being African American, being in a primary relationship, and a history of injection drug use or homelessness in the past year were associated with greater likelihood of nonadherence. Furthermore, adherence self-efficacy, and being able to manage side effects and fit medications into daily routines were protective against nonadherence. Being tired of taking medications was associated with poorer adherence whereas a belief that nonadherence can make the virus stronger was associated with better adherence. Conclusions: Results support the need for multifocused interventions to improve medication adherence that address logistical barriers, substance use, attitudes and expectancies, as well as skills building and self-efficacy enhancement. Further exploration of issues related to adherence for African Americans and men in primary relationships is warranted.
AB - Objectives: Adherence to antiretroviral therapy (ART) remains a challenge in efforts to maximize HIV treatment benefits. Previous studies of antiretroviral adherence are limited by low statistical power, homogeneous samples, and biased assessment methods. Based on Social Action Theory and using a large, diverse sample of men and women living with HIV, the objectives of the current study are to clarify correlates of nonadherence to ART and to provide theory-guided, empirically supported direction for intervening on ART nonadherence. Design: Cross-sectional interview study utilizing a computerized interview. Setting: Recruited from clinics, agencies, and via media ads in four U.S. cities from June 2000 to January 2002. Participants: Two thousand seven hundred and sixty-five HIV-positive adults taking ART. Main Outcome Measure: Computer-assessed self-reported antiretroviral adherence. Results: Thirty-two percent reported less than 90% adherence to ART in the prior 3 days. A number of factors were related to nonadherence in univariate analysis. Multivariate analyses identified that being African American, being in a primary relationship, and a history of injection drug use or homelessness in the past year were associated with greater likelihood of nonadherence. Furthermore, adherence self-efficacy, and being able to manage side effects and fit medications into daily routines were protective against nonadherence. Being tired of taking medications was associated with poorer adherence whereas a belief that nonadherence can make the virus stronger was associated with better adherence. Conclusions: Results support the need for multifocused interventions to improve medication adherence that address logistical barriers, substance use, attitudes and expectancies, as well as skills building and self-efficacy enhancement. Further exploration of issues related to adherence for African Americans and men in primary relationships is warranted.
UR - http://www.scopus.com/inward/record.url?scp=9144265457&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=9144265457&partnerID=8YFLogxK
U2 - 10.1089/108729103771928708
DO - 10.1089/108729103771928708
M3 - Article
C2 - 14746658
AN - SCOPUS:9144265457
VL - 17
SP - 645
EP - 656
JO - AIDS Patient Care and STDs
JF - AIDS Patient Care and STDs
SN - 1087-2914
IS - 12
ER -