title: Coercion or Caring: The Fundamental Paradox for Adherence Interventions for HIV+ People with Mental Illness.
abstract: To determine if an escalating HIV treatment adherence intervention would be considered by participants from a caring or coercive perspective, perceived coercion was examined in 238 community-based dually diagnosed individuals (HIV+ and a serious mental illness) randomized to a treatment-as-usual (TAU) control group or preventing AIDS through health for HIV+ persons (PATH+) Intervention that increased intervention intensity when adherence fell below 80 %. Minor differences were observed in perceived coercion between the PATH+ Intervention and Control groups with perceived coercion marginally higher in the PATH+ group. Latent growth curve analyses indicate that perceived coercion was not related to duration of the intervention for either the PATH+ or Control group. The experience of coercion by HIV+ individuals receiving community-based mental health services was not related to the intensity or duration of delivered services.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA. mme2@mail.med.upenn.edu.
authors.forename: Marlene M
authors.identifier: http://orcid.org/0000-0002-6042-058X
authors.initials: MM
authors.lastname: Eisenberg
authors.affiliation: Annenberg School of Communications, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Hennessy
authors.affiliation: Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Coviello
authors.affiliation: Bouve College of Health Sciences, Northeastern University, Boston, MA, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Hanrahan
authors.affiliation: Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Blank
mesh_terms: D000163:Acquired Immunodeficiency Syndrome; D000328:Adult; D003068:Coercion; D003156:Community Mental Health Services; D004645:Empathy; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D008875:Middle Aged; D010465:Perception
keywords: HIV+; Intervention cascade; Perceived coercion; Serious mental illness; Treatment adherence