title: Patient-perceived barriers to antiretroviral adherence: associations with race.
abstract: New antiretroviral (ARV) regimens require strict adherence if optimal suppression of HIV is to be maintained. This study is a theory-based examination of racial differences in patient-perceived barriers and reported ARV adherence. Participants (N=149) completed the Patient Medication Adherence Questionnaire (PMAQ), measuring adherence and perceived barriers to adherence. Adherence was defined as a self-report of 100% adherence in the past four weeks. Odds ratios were calculated to determine the relation of reported barriers to adherence for race and gender groups, and for the sample overall. For every ten-point increase in barrier score, there was an 86% increased risk of being non-adherent (OR=1.86; 95% CI: 1.19, 2.91). Adherence was not different between racial and gender groups, nor was total barrier score. However, individual barriers were differentially endorsed across groups. Rather than relying on demographic predictors, which may be only an indirect marker of adherence, evaluations of adherence should examine the psychological and social barriers to positive adherence outcomes in individual patients. Our findings support the use of theory-based behavioural interventions that address perceived barriers to adherence and other health promotion activities.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (UAB), 11th Avenue South, Medical Towers Suite 401, Birmingham, AL 35205-4410, USA. tferguson@dopm.uab.edu
authors.forename: T F
authors.initials: TF
authors.lastname: Ferguson
authors.forename: K E
authors.initials: KE
authors.lastname: Stewart
authors.forename: E
authors.initials: E
authors.lastname: Funkhouser
authors.forename: J
authors.initials: J
authors.lastname: Tolson
authors.forename: A O
authors.initials: AO
authors.lastname: Westfall
authors.forename: M S
authors.initials: MS
authors.lastname: Saag
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011446:Prospective Studies; D012737:Sex Factors; D012944:Social Support; D014481:United States / Q000208:ethnology; D044465:White People / Q000523:psychology
chemical_list: D019380:Anti-HIV Agents