title: Intention to adhere to HIV treatment: a patient-centred predictor of antiretroviral adherence.
abstract: OBJECTIVE
  Despite the effectiveness of highly active antiretroviral therapy (HAART), HIV remains a major cause of mortality in the USA, largely as a result of poor HIV treatment adherence. In this study we assessed the association between five patient-centred factors and adherence to HIV treatment.
  
  
  METHODS
  We surveyed 244 adults at two HIV clinics in Houston, Texas between October 2009 and April 2010. Participants were given a questionnaire and their charts were reviewed for clinical data. Survey items assessed the following factors: self-assessed HIV knowledge, awareness of disease biomarkers, intention to adhere to HIV treatment, health literacy and decision-making style. The primary outcome measure was HAART adherence during the previous month. Logistic regressions were performed to calculate the effect of each factor on adherence.
  
  
  RESULTS
  All participants had HIV/AIDS and were on HAART at enrolment. Eight per cent of participants were female, 57% were African-American and 16% were Hispanic. Mean age was 58.1 years. Sixty-eight per cent were adherent to HAART during the last month. On univariate analysis, a preference for wanting choices, correct knowledge of recent HIV viral load level, and intention to adhere to HIV treatment were significantly associated with adherence. On multivariate analysis, only intention to adhere to HIV treatment remained statistically significant after adjusting for other factors (odds ratio 2.2; 95% confidence interval 1.1 to 4.3).
  
  
  CONCLUSIONS
  Intention to adhere to HIV treatment was significantly associated with self-reported adherence to HAART. Interventions that bolster patients' intentions to adhere to HIV treatment during clinical encounters may improve adherence to HAART and HIV control.
authors.affiliation: Houston Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
authors.forename: A
authors.initials: A
authors.lastname: Nelsen
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: B W
authors.initials: BW
authors.lastname: Trautner
authors.forename: N J
authors.initials: NJ
authors.lastname: Petersen
authors.forename: A
authors.initials: A
authors.lastname: Garza
authors.forename: T P
authors.initials: TP
authors.lastname: Giordano
authors.forename: A D
authors.initials: AD
authors.lastname: Naik
authors.forename: M C
authors.initials: MC
authors.lastname: Rodriguez-Barradas
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D003625:Data Collection; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D057566:Self Report; D013781:Texas / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; adherence; highly active antiretroviral therapy; intention; predictors