title: Intentionality of medication non-adherence among individuals living with HIV/AIDS in Hong Kong.
abstract: Adherence to antiretroviral therapy is essential to treatment success for individuals living with HIV/AIDS. Despite the wealth of studies in examining antiretroviral non-adherence, few have distinguished between intentional and unintentional non-adherence. The present study attempted to identify factors associated with adherence, intentional non-adherence, and unintentional non-adherence among HIV+ individuals using a longitudinal design. Dietary instructions and medication schedule were also included to measure the subtleties of antiretroviral adherence. One hundred and two HIV+ patients who were under antiretroviral therapy were recruited in an outpatient clinic in Hong Kong at baseline with six months follow-up. Using the conventional adherence rate, only 12 (11.8%) of participants reported having missed/ altered medication in the past four days. However, using a more comprehensive assessment, only 27 (26.5%) participants were classified as adherers. Results showed that, adherers were significantly older and had higher adherence self-efficacy than those who were unintentional or intentional non-adherers. Participants classified as unintentional non-adherers had longer length of diagnosis and started medication longer than adherers and intentional non-adherers. Participants classified as intentional non-adherers had worse mental health, higher level of self-stigma, and reported higher score in avoidant coping than adherers and unintentional non-adherers. They also scored higher in physical symptoms than adherers. Findings highlight the importance of a reliable, comprehensive measurement for adherence and extend on previous adherence literature that intentional and unintentional non-adherence are separate entities and are associated with different factors. Future research should understand the intentions behind non-adherence and this would serve as an important guide in the development of interventions aimed at improving antiretroviral adherence for HIV+ patients.
authors.affiliation: Institute of Work, Health and Organisations, University of Nottingham, UK. lwxkhm1@nottingham.ac.uk
authors.forename: Phoenix K H
authors.initials: PK
authors.lastname: Mo
authors.forename: Winnie W S
authors.initials: WW
authors.lastname: Mak
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006723:Hong Kong; D006801:Humans; D033182:Intention; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008603:Mental Health; D012649:Self Concept; D013240:Stereotyping
chemical_list: D018501:Antirheumatic Agents