title: Spiritual and mind-body beliefs as barriers and motivators to HIV-treatment decision-making and medication adherence? A qualitative study.
abstract: We examined spiritual/mind-body beliefs related to treatment decision-making and adherence in 79 HIV-positive people (35% female, 41% African American, 22% Latino, 24% White) who had been offered antiretroviral treatment by their physicians. Interviews (performed in 2003) identified spiritual/mind-body beliefs; the Adult AIDS Clinical Trials Group (ACTG) questionnaire assessed adherence and symptoms/side effects. Decision-making was influenced by health-related spiritual beliefs (e.g., calling on God/Higher Power for help/protection, God/Higher Power controls health) and mind-body beliefs (e.g., mind controls body, body tells when medication is needed). Participants believing God/Higher Power controls health were 4.75 times more likely to refuse, and participants with mind-body beliefs related to decision-making were 5.31 times more likely to defer antiretrovirals than those without those beliefs. Participants believing spirituality helps coping with side effects reported significantly better adherence and fewer symptoms/side effects. Fewer symptoms/side effects were significantly associated with the beliefs mind controls body, calling on God/Higher Power for help/protection, and spirituality helps adherence. Spiritual/mind-body beliefs as barriers or motivators to taking or adhering to treatment are important, since they may affect survival and quality of life of HIV-positive people.
authors.affiliation: University of Miami, Department of Psychology, Behavioral Medicine Research Program, 1204 Dickinson Drive, Suite 37E, Coral Gables, FL 3324-2070, USA. H.Kremer@miami.edu
authors.forename: Heidemarie
authors.initials: H
authors.lastname: Kremer
authors.forename: Gail
authors.initials: G
authors.lastname: Ironson
authors.forename: Martina
authors.initials: M
authors.lastname: Porr
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003657:Decision Making; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D019222:Mind-Body Relations, Metaphysical; D010349:Patient Compliance; D012067:Religion; D029181:Spirituality; D011795:Surveys and Questionnaires; D016312:Treatment Refusal
chemical_list: D019380:Anti-HIV Agents