title: Psychosocial Characteristics Associated with Both Antiretroviral Therapy Adherence and Risk Behaviors in Women Living with HIV.
abstract: The purpose of this study was to identify key psychosocial characteristics of HIV-infected women who exhibit different levels of both ART adherence and risk behaviors. We analyzed baseline data from 193 predominately African American HIV-infected women participating in a behavioral clinical trial. Women were categorized into high/low groups based on levels of adherence and risky behaviors. There was a significant interaction effect for internal motivation for adherence. Women at high risk for poor health and transmitting HIV (low adherence/high risk group) had the lowest levels of internal motivation and also reported more difficult life circumstances. Gender roles, caretaking and reliance on men for economic and other support may promote external versus internal motivation as well as riskier behaviors in this group. The highest levels of internal motivation were found in those with High Adherence/High Risk behaviors. This group was highly knowledgeable about HIV and had the lowest VL. Compared to others, this group seems to tolerate risky behaviors given their high level of adherence. Adherence and risk reduction behaviors are key to individual and public health. Motivation and risk compensation should be addressed when providing interventions to women living with HIV.
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA. nurmmcd@emory.edu.
authors.forename: Marcia McDonnell
authors.initials: MM
authors.lastname: Holstad
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA.
authors.forename: Sydney
authors.initials: S
authors.lastname: Spangler
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA.
authors.forename: Melinda
authors.initials: M
authors.lastname: Higgins
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA.
authors.forename: Safiya George
authors.initials: SG
authors.lastname: Dalmida
authors.affiliation: School of Medicine, Emory University, 1520 Clifton Road, Atlanta, GA, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D006801:Humans; D055118:Medication Adherence / Q000208:ethnology / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D020377:Self Efficacy; D012959:Socioeconomic Factors
keywords: ART; Antiretroviral medication adherence; Difficult life circumstances; HIV/AIDS; Motivation; Self-efficacy; Sexual risk behavior