Predictors of medication adherence among HIV-positive women in North America

J Obstet Gynecol Neonatal Nurs. 2014 Mar-Apr;43(2):168-78. doi: 10.1111/1552-6909.12288. Epub 2014 Feb 6.

Abstract

Objective: To explore the relationships among contextual, environmental, and regulatory factors with antiretroviral (ARV) medication adherence to assist care providers in improving care for women living with HIV.

Design: Descriptive, multicenter study.

Setting: Sixteen HIV clinics and service organizations in North America.

Participants: This convenience 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. We included 383 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 in relation to adherence to ARV medication. Descriptive and multivariate statistics were used to examine the effects of these factors on self-reported ARV drug adherence.

Results: Age, depression symptoms, stigma, 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.

Keywords: HIV; adherence; antiretroviral; social action theory; women.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anti-HIV Agents / administration & dosage*
  • Cohort Studies
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Seropositivity / drug therapy
  • HIV Seropositivity / epidemiology
  • Humans
  • Incidence
  • Medication Adherence / ethnology*
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Needs Assessment
  • North America
  • Patient Education as Topic / organization & administration
  • Regression Analysis
  • Risk Assessment
  • Self Efficacy
  • Socioeconomic Factors
  • Young Adult

Substances

  • Anti-HIV Agents