title: Medication adherence mediates the relationship between adherence self-efficacy and biological assessments of HIV health among those with alcohol use disorders.
abstract: The current study examines the relationship between negative consequences of alcohol use, adherence self-efficacy, medication adherence, and biological markers of HIV health (CD4 count and viral load). A total of 275 HIV-positive men and women with alcohol use disorders were surveyed using Audio-CASI measures and time line followback interviews. Findings from a structural equation model suggest that negative consequences related to alcohol use did not directly impact HIV health. Adherence self-efficacy had direct effects on viral load, but not CD4 count. Mediation analyses indicated that self-reported adherence partially mediated the relationship between adherence self-efficacy and viral load. Cognitive-oriented interventions aimed at facilitating adherence self-efficacy may be effective in improving both medication adherence and HIV health. If facilitating confidence improves HIV health, then health care providers can make a strong impact by spending a few short minutes themselves and/or partnering with behavioral health clinicians using techniques like motivational enhancement.
authors.affiliation: Department of Psychology, Hunter College of the City University of New York, Center for HIV/AIDS Educational Studies and Training (CHEST), 695 Park Avenue, New York, NY 10021, USA. jeffrey.parsons@hunter.cuny.edu
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Parsons
authors.forename: Elana
authors.initials: E
authors.lastname: Rosof
authors.forename: Brian
authors.initials: B
authors.lastname: Mustanski
mesh_terms: D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000150:complications*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology / Q000821:virology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009042:Motivation; D010349:Patient Compliance; D020377:Self Efficacy; D019562:Viral Load