title: Social support, coping, and medication adherence among HIV-positive women with depression living in rural areas of the southeastern United States.
abstract: This study examined the relationships among sociodemographic factors, social support, coping, and adherence to antiretroviral therapy (ART) among HIV-positive women with depression. The analyses reported here were limited to the 224 women receiving ART of 280 women recruited from community-based HIV/AIDS organizations serving rural areas of three states in the southeastern United States. Two indicators of medication adherence were measured; self-report of missed medications and reasons for missed medications in the past month. Descriptive statistics, correlation, and regression analyses were performed to systematically identify sociodemographic, coping, and social support variables that predicted medication adherence. In regression analysis, three variables were determined to be significant predictors accounting for approximately 30% of the variability in the self-report of reasons for missed medications. Coping focused on managing HIV disease was negatively associated, while coping focused on avoidance/denial and number of children were positively associated with reasons for missed medications. Coping by spiritual activities and focusing on the present mediated the effect of social support on self-reported missed medications. The relationship of predictor variables to self-report of missed medications was assessed using t test statistics and logistic regression analysis to determine the odds of self-reported medication adherence. Satisfaction with social support (p = 0.04), and coping focused on managing HIV disease (p = 0.002) were the best positive predictors, whereas number of children (p = 0.02) was the lone significant negative predictor of medication adherence. The study findings have implications for designing, implementing, and testing interventions based on social support and coping theories for achieving better adherence to HIV medications.
authors.affiliation: Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA. medha@sc.edu
authors.forename: Medha
authors.initials: M
authors.lastname: Vyavaharkar
authors.forename: Linda
authors.initials: L
authors.lastname: Moneyham
authors.forename: Abbas
authors.initials: A
authors.lastname: Tavakoli
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Phillips
authors.forename: Carolyn
authors.initials: C
authors.lastname: Murdaugh
authors.forename: Kirby
authors.initials: K
authors.lastname: Jackson
authors.forename: Gene
authors.initials: G
authors.lastname: Meding
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D012044:Regression Analysis; D012423:Rural Health; D012944:Social Support; D015144:Southeastern United States
chemical_list: D044966:Anti-Retroviral Agents