title: Adherence to antiretroviral medication regimens: a test of a psychosocial model.
abstract: OBJECTIVE
  The primary aim of this study was to test a psychosocial model of medication adherence among people taking antiretroviral medications. This model was based primarily on social cognitive theory and included personal (self-efficacy, outcome expectancy, stigma, depression, and spirituality), social (social support, difficult life circumstances), and provider (patient satisfaction and decision-making) variables.
  
  
  METHODS
  The data for this analysis were obtained from the parent study, which was a randomized controlled trial (Get Busy Living) designed to evaluate an intervention to foster medication adherence. Factor analysis was used to develop the constructs for the model, and structural equation modeling was used to test the model. Only baseline data were used in this cross sectional analysis.
  
  
  METHODS
  Participants were recruited from a HIV/AIDS clinic in Atlanta, GA. Prior to group assignment, participants were asked to complete a questionnaire that included assessment of the study variables. Results A total of 236 participants were included in the analysis. The mean age of the participants was 41 years; the majority were male, and most were African-American. In the final model, self-efficacy and depression demonstrated direct associations with adherence; whereas stigma, patient satisfaction, and social support were indirectly related to adherence through their association with either self-efficacy or depression.
  
  
  CONCLUSIONS
  These findings provide evidence to reinforce the belief that medication-taking behaviors are affected by a complex set of interactions among psychosocial variables and provide direction for adherence interventions.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd., Room: 560, Atlanta, GA, 30322, USA. cdiiori@sph.emory.edu.
authors.forename: Colleen
authors.initials: C
authors.lastname: Diiorio
authors.forename: Frances
authors.initials: F
authors.lastname: McCarty
authors.forename: Lara
authors.initials: L
authors.lastname: Depadilla
authors.forename: Ken
authors.initials: K
authors.lastname: Resnicow
authors.forename: Marcia McDonnell
authors.initials: MM
authors.lastname: Holstad
authors.forename: Katherine
authors.initials: K
authors.lastname: Yeager
authors.forename: Sanjay M
authors.initials: SM
authors.lastname: Sharma
authors.forename: Donald E
authors.initials: DE
authors.lastname: Morisky
authors.forename: Brita
authors.initials: B
authors.lastname: Lundberg
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D008960:Models, Psychological; D011581:Psychological Tests; D011584:Psychology; D020377:Self Efficacy; D012944:Social Support; D029181:Spirituality; D013240:Stereotyping; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents