Psychiatric morbidity and adherence to antiretroviral medication in patients with HIV/AIDS.
OBJECTIVE
To determine whether psychological morbidity is associated with poor compliance with antiretroviral medication in HIV-positive subjects.


METHODS
This is a cross-sectional survey of patients attending a public HIV clinic in Sydney. Volunteers completed a survey which gathered data on substance use, psychological distress, attitudes to illness and medication, and self-reported medication adherence. Psychological morbidity was assessed using the 28 question General Health Questionnaire, GHQ-28, and adherence was assessed using a combination of direct self-report and indirect questions.


RESULTS
Forty-four per cent of subjects were identified as suffering psychological disorder on the GHQ. They reported significantly poorer adherence to antiretroviral medication than subjects not identified as 'cases' (odds ratio 4.5). Expressed scepticism about medication and previous use of psychotropics was also associated with poor adherence.


CONCLUSIONS
Psychological morbidity is associated with poor adherence to antiretroviral medication. It is not known whether treatment of identified psychological morbidity leads to improved antiretroviral medication adherence and better medical outcome. A longitudinal study could help answer this question.
Sternhell
Peter S
PS
Department of Consultation-Liaison Psychiatry, St Vincent's Hospital, Level 13 Aikenhead Building, Victoria Street, Darlinghurst 2010, New South Wales, Australia. psternhell@stvincents.com.au
Corr
Melissa J
MJ
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance / Q000523:psychology*; D010555:Personality Inventory; D012803:Sick Role
D019380:Anti-HIV Agents