title: Medication adherence in HIV-positive patients with diabetes or hypertension: a focus group study.
abstract: BACKGROUND
  People with HIV are living longer with potent antiretroviral therapy (ART), and HIV is increasingly complicated by other chronic medical comorbidities. The objective of this study was to explore HIV-positive patients' perspectives on living with HIV and diabetes mellitus (DM) or hypertension (HTN) and factors affecting medication adherence.
  
  
  METHODS
  We conducted six focus groups. Two investigators independently coded transcripts for thematic content using editing style analysis. Codes were grouped into conceptual themes using consensus process.
  
  
  RESULTS
  Thirty-five HIV-positive patients with diabetes or hypertension participated. Four major themes emerged: (1) Comorbidities are a source of concern and frustration, sometimes eclipsing concern regarding HIV (2) Understanding of health conditions and medications promotes adherence, (3) Simpler regimens with fewer side effects promote adherence, and (4) Untreated substance abuse and mental health issues hinder adherence.
  
  
  CONCLUSIONS
  HIV-positive patients in this study voiced concern regarding medical comorbidities and highlighted patient understanding, regimen factors, and substance abuse/mental health issues as barriers to adherence. Addressing these issues may improve outcomes in the aging HIV-positive population. Adherence to medications among HIV-positive patients with DM or HTN may be influenced by providing targeted disease-specific education, simplifying regimens, and treatment of substance abuse/mental health issues.
authors.affiliation: Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. amonroe4@jhmi.edu.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Monroe
authors.forename: Tashi L
authors.initials: TL
authors.lastname: Rowe
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.forename: Geetanjali
authors.initials: G
authors.lastname: Chander
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D048909:Diabetes Complications / Q000523:psychology; D003920:Diabetes Mellitus / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000523:psychology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology
chemical_list: D019380:Anti-HIV Agents