Predictors of Self-Reported Adherence to Antiretroviral Medication in a Multisite Study of Ethnic and Racial Minority HIV-Positive Youth.
OBJECTIVE
To test social cognitive predictors of medication adherence in racial/ethnic minority youth living with HIV using a conceptual model.


METHODS
Youth were participants in two descriptive studies by the Adolescent Trials Network for HIV/AIDS Interventions. Minority youth ages 16-24 years who were prescribed antiretroviral medication were included (N = 956). Data were collected through chart extraction and/or laboratory testing and by Audio Computer-Assisted Self-Interview.


RESULTS
39% of youth reported suboptimal adherence. Path analysis was used to explore predictors of medication adherence. Higher self-efficacy predicted higher readiness and adherence. Greater social support predicted higher self-efficacy. Psychological symptoms and substance use were associated with several predictors and lower adherence.


CONCLUSIONS
The model provided a plausible framework for understanding adherence in this population. Culturally competent, but individually tailored, interventions focused on increasing self-efficacy to take medication and reducing risk behaviors (e.g., substance use) may be helpful for racial or ethnic minority youth with HIV.
Wayne State University, kkolmodin@med.wayne.edu.
Karen Kolmodin
KK
MacDonell
Wayne State University.
Angela J
AJ
Jacques-Tiura
Wayne State University.
Sylvie
S
Naar
Nova Southeastern University, and.
Maria Isabella
MI
Fernandez
D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002908:Chronic Disease; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data; D044469:Racial Groups / Q000523:psychology* / Q000706:statistics & numerical data; D020377:Self Efficacy; D057566:Self Report; D012944:Social Support; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology; D014481:United States; D055815:Young Adult; D016903:Drug Monitoring
HIV/Aids; adolescents; chronic illness; disparities; health behavior; psychosocial functioning; race/ethnicity