title: Positive provider interactions, adherence self-efficacy, and adherence to antiretroviral medications among HIV-infected adults: A mediation model.
abstract: Adherence to antiretroviral (ARV) therapy for HIV infection is critical for maximum benefit from treatment and for the prevention of HIV-related complications. There is evidence that many factors determine medication adherence, including adherence self-efficacy (confidence in one's ability to adhere) and relations with health care providers. However, there are no studies that examine how these two factors relate to each other and their subsequent influence on HIV medication adherence. The goal of the current analysis was to explore a model of medication adherence in which the relationship between positive provider interactions and adherence is mediated by adherence self-efficacy. Computerized self-administered and interviewer-administered self reported measures of medication adherence, demographic and treatment variables, provider interactions, and adherence self-efficacy were administered to 2765 HIV-infected adults on ARV. Criteria for mediation were met, supporting a model in which adherence self-efficacy is the mechanism for the relationship between positive provider interactions and adherence. The finding was consistent when the sample was stratified by gender, race, injection drug use history, and whether the participant reported receipt of HIV specialty care. Positive provider interactions may foster greater adherence self-efficacy, which is associated with better adherence to medications. Results suggest implications for improving provider interactions in clinical care, and future directions for clarifying interrelationships among provider interactions, adherence self-efficacy, and medication adherence are supported.
authors.affiliation: Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California 94105, USA. Mallory.Johnson@ucsf.edu
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Chesney
authors.forename: Rise B
authors.initials: RB
authors.lastname: Goldstein
authors.forename: Robert H
authors.initials: RH
authors.lastname: Remien
authors.forename: Sheryl
authors.initials: S
authors.lastname: Catz
authors.forename: Cheryl
authors.initials: C
authors.lastname: Gore-Felton
authors.forename: Edwin
authors.initials: E
authors.lastname: Charlebois
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Morin
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003142:Communication; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D017008:Negotiating; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D020377:Self Efficacy
chemical_list: D019380:Anti-HIV Agents