title: Associations among correlates of schedule adherence to antiretroviral therapy (ART): a path analysis of a sample of crack cocaine using sexually active African-Americans with HIV infection.
abstract: Adherence to HIV medication regimens is a function of multiple dimensions including psychological functioning, social support, adherence self-efficacy and optimism regarding treatment. Active substance use can also negatively affect adherence. An understanding of the nature of the associations among the correlates of adherence can better inform the design of interventions to improve adherence. This study developed an exploratory path model of schedule adherence using data from a sample 130 African-American HIV-positive crack cocaine users on highly active antiretroviral therapy (ART). This model was based on the Transactional Model of Stress and Coping developed by Lazarus and Folkman. Following the theory, the effects of psychological distress on schedule adherence were mediated by patients' relationship with their doctor and optimism towards antiretroviral treatment. Adherence was also associated with patients' self-efficacy regarding their medical regimen which, in turn, was associated with their social support.
authors.affiliation: School of Public Health, University of Texas Health Science Center at Houston, 7000 Fannin Street, Houston, TX 77030, USA. John.S.Atkinson@uth.tmc.edu
authors.forename: J S
authors.initials: JS
authors.lastname: Atkinson
authors.forename: L Nilsson
authors.initials: LN
authors.lastname: Schönnesson
authors.forename: M L
authors.initials: ML
authors.lastname: Williams
authors.forename: S C
authors.initials: SC
authors.lastname: Timpson
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active; D001294:Attitude to Health; D019970:Cocaine-Related Disorders / Q000523:psychology*; D016578:Crack Cocaine; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D020377:Self Efficacy; D012944:Social Support; D013315:Stress, Psychological
chemical_list: D016578:Crack Cocaine