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Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model

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Abstract

Objective The primary aim of this study was to test a psychosocial model of medication adherence among people taking antiretroviral medications. This model was based primarily on social cognitive theory and included personal (self-efficacy, outcome expectancy, stigma, depression, and spirituality), social (social support, difficult life circumstances), and provider (patient satisfaction and decision-making) variables. Design The data for this analysis were obtained from the parent study, which was a randomized controlled trial (Get Busy Living) designed to evaluate an intervention to foster medication adherence. Factor analysis was used to develop the constructs for the model, and structural equation modeling was used to test the model. Only baseline data were used in this cross sectional analysis. Methods Participants were recruited from a HIV/AIDS clinic in Atlanta, GA. Prior to group assignment, participants were asked to complete a questionnaire that included assessment of the study variables. Results A total of 236 participants were included in the analysis. The mean age of the participants was 41 years; the majority were male, and most were African-American. In the final model, self-efficacy and depression demonstrated direct associations with adherence; whereas stigma, patient satisfaction, and social support were indirectly related to adherence through their association with either self-efficacy or depression. Conclusion These findings provide evidence to reinforce the belief that medication-taking behaviors are affected by a complex set of interactions among psychosocial variables and provide direction for adherence interventions.

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Acknowledgments

This study was funded by a grant from the National Institute of Nursing Research R01 NR04857. We wish to acknowledge the assistance of the Infectious Disease Program in the conduction of this study. We appreciate the assistance of the staff and the contributions of the participants who enrolled in the study.

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Authors and Affiliations

  1. Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd., Room: 560, Atlanta, GA, 30322, USA

    Colleen DiIorio & Lara DePadilla

  2. Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1520 Clifton Rd., Room: 224, Atlanta, GA, 30322, USA

    Frances McCarty & Katherine Yeager

  3. Health Behavior & Health Education School of Public Health, University of Michigan, 1420 Washington Heights (SPH II) Room 5009, Ann Arbor, MI, 48109-2029, USA

    Ken Resnicow

  4. Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd., Room 310, Atlanta, GA, 30322, USA

    Marcia McDonnell Holstad

  5. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 341 Ponce de Leon Avenue, Room 402, Atlanta, GA, USA

    Sanjay M. Sharma

  6. Department of Community Health Sciences, UCLA School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA

    Donald E. Morisky

  7. 5 Oakwood Terrace, Newton Centre, MA, 02459, USA

    Brita Lundberg

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  1. Colleen DiIorio
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  2. Frances McCarty
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Correspondence to Colleen DiIorio.

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DiIorio, C., McCarty, F., DePadilla, L. et al. Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model. AIDS Behav 13, 10–22 (2009). https://doi.org/10.1007/s10461-007-9318-4

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