title: Adherence of human immunodeficiency virus-infected patients to antiretroviral therapy.
abstract: The impact of demographic, psychosocial, and medical regimen-related variables on adherence of 123 human immunodeficiency virus (HIV)-infected patients to antiretroviral therapy was assessed by means of refill methodology. Satisfaction with social support (P = .029), problem-focused coping (P = .027), and active-behavioral coping (P = .011) correlated significantly with adherence, whereas loss of motivation (P = .006), hopelessness (P = .16), and avoidant coping (p = .015) correlated with nonadherence. At the 6-month follow-up, the mean CD4 cell count differed significantly among adherent versus nonadherent patients (a mean increase of 78/mm3 vs. a mean decrease of 5/mm3; P = .018). Adherence did not correlate with the number of antiretroviral medications consumed per day (mean, 3.0 vs. 2.5). Non-Caucasian patients were more likely to be nonadherent than Caucasian patients (relative risk, 2.5; 95% confidence interval, 1.2-5.3; P = .013); this difference was not explained by age, education, employment, income, history of intravenous drug use, or medical regimen. Non-Caucasian patients, however, were less satisfied with their social support (P = .04) and informational support (P = .016) and were more likely to utilize emotion-focused coping (P = .01). Thus, satisfaction with social support and coping style significantly impacted adherence and likely accounted for the observed racial difference in adherence among HIV-infected patients.
authors.affiliation: Infectious Disease Section, Veterans Affairs Medical Center, Pittsburgh, Pennsylvania 15240, USA.
authors.forename: N
authors.initials: N
authors.lastname: Singh
authors.forename: S M
authors.initials: SM
authors.lastname: Berman
authors.forename: S
authors.initials: S
authors.lastname: Swindells
authors.forename: J C
authors.initials: JC
authors.lastname: Justis
authors.forename: J A
authors.initials: JA
authors.lastname: Mohr
authors.forename: C
authors.initials: C
authors.lastname: Squier
authors.forename: M M
authors.initials: MM
authors.lastname: Wagener
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D011788:Quality of Life; D012944:Social Support
chemical_list: D019380:Anti-HIV Agents