Annals of Behavioral Medicine

, 34:46

Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence

  • Jeffrey S. Gonzalez
  • Frank J. Penedo
  • Maria M. Llabre
  • Ron E. Durán
  • Michael H. Antoni
  • Neil Schneiderman
  • Rob Horne
Article

Abstract

Background: Near-perfect levels of HIV medication adherence are necessary for treatment to be successful. However, many patients continue to report nonadherence to HIV treatment.Purpose: This study examines the relationship between symptoms of HIV and medication adherence and evaluates beliefs about HIV medications and negative mood states as potential mediators of this relationship.Methods: These relationships were tested with structural equation modeling using a 15-month longitudinal design. The ethnically diverse convenience sample included 325 HIV-infected men who have sex with men and women prescribed Highly Active Antiretroviral Therapy (HAART).Results: Results showed that a greater number of symptoms were associated with poorer medication adherence, and this relationship was partially mediated by increases in concerns about HAART. Contrary to expectations, negative mood states were not directly related to medication adherence. In the final model, concerns about HAART and general distrust of medications each predicted poorer HAART adherence. Necessity beliefs about HAART and level of educational attainment each predicted better adherence. The final model accounted for approximately 24% of the variance in HAART adherence.Conclusions: The results of this study suggest that Horne’s (1) necessity-concerns framework can be successfully applied to identify beliefs about medication that are important predictors of adherence to HAART over time. These findings have relevance for developing interventions to improve medication adherence among HIV-infected patients.

Copyright information

© The Society of Behavioral Medicine 2007

Authors and Affiliations

  • Jeffrey S. Gonzalez
    • 1
  • Frank J. Penedo
    • 3
  • Maria M. Llabre
    • 3
  • Ron E. Durán
    • 4
  • Michael H. Antoni
    • 3
  • Neil Schneiderman
    • 3
  • Rob Horne
    • 5
  1. 1.Harvard Medical SchoolMassachusetts General HospitalUSA
  2. 2.Department of PsychiatryMassachusetts General HospitalBoston
  3. 3.University of MiamiUSA
  4. 4.Alliant International UniversityUSA
  5. 5.The School of PharmacyUniversity of LondonUK

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