title: Examination of the Role of Religious and Psychosocial Factors in HIV Medication Adherence Rates.
abstract: Optimal adherence to antiretroviral therapy (ART) is associated with favorable HIV outcomes, including higher CD4 cell counts, HIV virus suppression and a lower risk of HIV transmission. However, only 25% of people living with HIV/AIDS (PLWH) in the USA are virally suppressed. Sub-optimal adherence (<90-95%) contributes to antiretroviral resistance and worse medical outcomes, including more rapid progression to AIDS and death. Psychosocial factors and religion/spirituality (R/S) have a significant impact on ART adherence, but the findings are mixed. The purpose of this study was to examine religious and psychosocial correlates and predictors of ≥90% ART adherence in PLWH. A cross-sectional study was conducted with a sample of 292 outpatient PLWH in the Southeastern USA. Participants completed computerized surveys. The mean ART adherence percentage was 80.9% and only about half reported ≥90% adherence. There were statistically significant differences in ART adherence rates based on age, depressive symptom status and frequency of religious attendance and prayer. Praying at least once a day was significantly associated with ≥90% ART adherence (OR = 2.26, 95% CI [1.06-4.79], p < 0.05). Social support satisfaction was also significantly associated with ART adherence (OR = 1.52, 95% CI [1.11-2.08], p < 0.05) and energy/fatigue/vitality (OR = 1.03, 95% CI [1.00-1.05], p < 0.05).
authors.affiliation: Capstone College of Nursing, The University of Alabama, 650 University Blvd, Tuscaloosa, AL, 35487, USA. sfgeorge@ua.edu.
authors.forename: Safiya George
authors.initials: SG
authors.lastname: Dalmida
authors.affiliation: School of Nursing and Health Studies, University of Washington, Bothell, WA, USA.
authors.forename: Katryna
authors.initials: K
authors.lastname: McCoy
authors.affiliation: Department of Psychiatry, Duke University Medical Center, Durham, NC, USA.|Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Harold G
authors.initials: HG
authors.lastname: Koenig
authors.affiliation: College of Health Sciences, Walden University, Minneapolis, MN, USA.
authors.forename: Aretha
authors.initials: A
authors.lastname: Miller
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
authors.forename: Marcia McDonnell
authors.initials: MM
authors.lastname: Holstad
authors.affiliation: Nicole Werthiem College of Nursing and Health Sciences, Florida International University, Miami, FL, USA.
authors.forename: Tami
authors.initials: T
authors.lastname: Thomas
authors.affiliation: College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
authors.forename: Dora
authors.initials: D
authors.lastname: Clayton-Jones
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Grant
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
authors.forename: Terri
authors.initials: T
authors.lastname: Fleming
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
authors.forename: Menka Munira
authors.initials: MM
authors.lastname: Wirani
authors.affiliation: College of Education, The University of Alabama, Tuscaloosa, AL, USA.
authors.forename: George
authors.initials: G
authors.lastname: Mugoya
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D012068:Religion and Medicine; D012944:Social Support; D015144:Southeastern United States; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents
keywords: Antiretroviral therapy; HIV/AIDS; Medication adherence; Religion; Spirituality