title: Applying an expanded social determinant approach to the concept of adherence to treatment: the case of Colombian women living with HIV/AIDS.
abstract: BACKGROUND
  The purpose of this study was to explore and analyze social determinants that influence adherence among Colombian women living with HIV/AIDS in poverty conditions.
  
  
  METHODS
  A qualitative, descriptive-interpretative study was developed. Forty-seven women participated in five focus group discussions. Also, in-depth interviews with six women were conducted.
  
  
  RESULTS
  Results showed that women with lower adherence sell their antiretroviral medication to satisfy economic needs, and prioritize the care of their HIV-positive children over their own adherence needs. In contrast, women with higher adherence were found to participate in social support groups offered by nongovernmental organizations.
  
  
  CONCLUSIONS
  These findings underscore the need to understand the social determinants that facilitate and/or hinder adherence among women in poverty-associated conditions. Results indicate the need to facilitate access to treatment on a timely and continual basis; provide economic resources, including support to meet basic needs as well as subsidies for transportation to health care centers; and explore mechanism for supporting the care of their offspring.
authors.affiliation: Department of Social Sciences, Pontificia Universidad Javeriana Cali, Calle 18 No. 118-250, Cali, Colombia. marceq@javerianacali.edu.co
authors.forename: Marcela
authors.initials: M
authors.lastname: Arrivillaga
authors.forename: Michael
authors.initials: M
authors.lastname: Ross
authors.forename: Bernardo
authors.initials: B
authors.lastname: Useche
authors.forename: Andrew
authors.initials: A
authors.lastname: Springer
authors.forename: Diego
authors.initials: D
authors.lastname: Correa
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003105:Colombia; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D055118:Medication Adherence / Q000208:ethnology* / Q000523:psychology; D008875:Middle Aged; D011203:Poverty / Q000523:psychology; D036301:Qualitative Research; D012931:Social Environment; D012944:Social Support; D013315:Stress, Psychological; D013637:Tape Recording; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents