International Journal of Behavioral Medicine

, Volume 14, Issue 3, pp 141–150

Psychosocial predictors of medication adherence among persons living with HIV

  • Aurélie Gauchet
  • Cyril Tarquinio
  • Gustave Fischer
Article

Abstract

Background: Since the introduction of highly active antiretroviral therapy (HAART), many have learned to live with HIV as a chronic illness. Adherence to medical regimens is extremely important for HIV patients. Purpose: To examine the extent to which medication adherence among HIV patients is related to social and psychological variables. Method: Data were gathered among 127 HIV patients (aged from 18 & #x2013;65 years) recruited at their quarterly consultation at Metz Hospital (France). Subjects completed a self-report adherence to medication scale, the Illness PerceptionQuestionnaire (IPQ), the Beliefs about Medicine Questionnaire (BMQ), a French Value System Scale, a treatment satisfaction scale, and sociodemographic measures. Results: Analyses revealed significant associations between adherence and patients’ beliefs about treatment, satisfaction with treatment, confidence in the physician, some values (“other people, ” “god and children”), and duration of treatment and illness. Conclusion: The data suggest that patients’ beliefs about treatment are formed to a certain degree in the patients’ relationship with the physician. Furthermore, adherence seems to be related to personal values.

Key words

medication adherence HIV infection values believes self regulatory model 

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References

  1. Abraham, C., & Hampson, S. E. (1996). A social cognition approach to health psychology: Philosophical andmethodological issues.Psychology and Health, 11, 223–241.CrossRefGoogle Scholar
  2. Alonzo, A. A., & Reynolds, N. R. (1995). Stigma, HIV, and AIDS: An exploration and elaboration of the illness trajectory surrounding HIV infection and AIDS.Social Science and Medicine, 41, 303–315.PubMedCrossRefGoogle Scholar
  3. Ammassari, A., Murri, R., Pezzotti, P., Paola Trotta, M., Ravasio, L., & De Longis, P., et al. (2001). Self-reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV-infection.Journal of Acquired Immune Deficiency Syndromes, 28, 445–449.PubMedGoogle Scholar
  4. Antoni, M. H., Carrico, A. W., Duran, R. E., Spitzer, S. S., Penedo, F., Ironson, G., Fletcher, M. A., Klimas, N., & Schneidermann, N. (2006). Randomized clinical trial of cognitive behavioral stress management on human immunodeficiency virus load in gay men treated with highly active antiretroviral therapy.Psychosomatic Medicine, 68, 143–151.PubMedCrossRefGoogle Scholar
  5. Bakken, S., Holzemer, W. L., Brown, M. A., Powell-Cope, G. M., Turner, J. G., Jnouye, J., Nokes, K. M., & Corless, I. B. (2000). Relationships between perception of engagement with health care provider and demographic characteristics, health status, and adherence to therapeutic regimen in persons with HIV/AIDS.AIDS Patient Care and STDS, 14, 189–197.PubMedCrossRefGoogle Scholar
  6. Bangsberg, D. R., Hecht, F. M., Charlebois, E. D., Zolopa, A. R., Holodniy, M., Sheiner, J. D., Chesney, M. A., & Moss, A. (2000). Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population.AIDS, 14, 357–366.PubMedCrossRefGoogle Scholar
  7. Bentler, P. M. (1990). Comparative fit indexes in structural models.Psychological Bulletin, 107, 238–247.PubMedCrossRefGoogle Scholar
  8. Bollen, K. A., & Long, J. S. (1993). Testing structural equation models.Psychological Bulletin, 107, 238–246.Google Scholar
  9. Browne, M.W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.),Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.Google Scholar
  10. Cattell, R. B. (1995). The fallacy of five factors in the personality sphere.The Psychologist, May, 207–208.Google Scholar
  11. Chesney, M. A., Ickowics, J. R., Chambers, D. B., Gifford, A. L., Neidig, J., Zwickl, B., et al. (2000a). Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The AACTG adherence instruments.AIDS Care, 12, 255–266.PubMedCrossRefGoogle Scholar
  12. Chesney, M. A., Morin, M., & Sherr, L. (2000b). Adherence to HIV combination therapy.Social Science & Medicine, 50, 1599–1605.CrossRefGoogle Scholar
  13. Cohen, S., Underwood, L. G., & Gottlieb, B. H. (2000).Social support measurement and intervention: A guide for health and social scientists. New York: Oxford University Press.Google Scholar
  14. Connor, A. P., Wicker, C. A., & Germino, B. B. (1990). Understanding the cancer patient’s search for meaning.Cancer Nursing, 13, 167–175.CrossRefGoogle Scholar
  15. Davis, M. S., Canniff, J. M, & Andradas, V. (1997). Successful ritonavir induction with intensive patient management. Fourth Conference on Retrovirus and Opportunistic Infections, Washington, DC.Google Scholar
  16. Diefenbach, M. A., & Leventhal, H. (1996). The common-sense model of illness representation: theoretical and practical considerations.Journal of Social Distress and the Homeless, 5, 11–38.CrossRefGoogle Scholar
  17. Fischer, G. N., & Tarquinio, C. (2002).Traitéde psychologie de la santé. Paris: Dunod.Google Scholar
  18. Haynes, R. B., McDonald, H. P., & Garg, A. X. (2002). Helping patients follow prescribed treatment clinical applications.Journal of the American Medical Association, 288(22), 2880–2883.PubMedCrossRefGoogle Scholar
  19. Horne, R. (1997). Representations of medication and treatment: Advances in theory andmeasurement. In K. J. Petrie & J. Weinman (Eds.),Percpetions of Health and Illness: Current Research and Applications (pp. 155–187). London: Harwood Academic.Google Scholar
  20. Horne, R., Buick, D., Fischer, M. Leake, H., Cooper, V., & Weinman, J. (2004). Doubts about necessity and concerns about adverse effects: Identifying the types of beliefs that are associated with non-adherence to HAART.International Journal of STD & AIDS, 15, 38–39.CrossRefGoogle Scholar
  21. Horne, R., & Weinman, J. (1999). Patient’s beliefs about prescibed medicines and their role in adherence to treatment in chronic physical illness.Journal of Psychosomatic Research, 47, 555–567.PubMedCrossRefGoogle Scholar
  22. Horne, R., Weinman, J., & Hankins, M. (1999). The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication.Psychology and Health, 14, 1–24.CrossRefGoogle Scholar
  23. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives.Structural Equation Modelling, 6, 1–55.CrossRefGoogle Scholar
  24. Ickovics, J. R., & Meisler, A. W. (1997). Adherence in AIDS clinical trials: A framework for clinical research and clinical care.Journal of Clinical Epidemiology, 50, 385–391.PubMedCrossRefGoogle Scholar
  25. Ironson, G., O’Cleirigh, C., Fletcher, M. A., Laurenceau, J. P., Balbin, E., Klimas, N., Schneidermann, N., & Solomon, G. (2005). Psychosocial factors predicts CD4 and viral load change in men and women with human immunodeficiency virus in the era of highly active antiretroviral treatment.Psychosomatic Medicine, 67, 1013–1021.PubMedCrossRefGoogle Scholar
  26. Jenkins, R. A. (1995). Religion and HIV: Implications for research and intervention.Journal of Social Issues, 51, 131–144.CrossRefGoogle Scholar
  27. Jenkins, R. A., & Pargament, K. I. (1995). Religion and spirituality as resources for coping with cancer. In M. R. Somerfield (Ed.),Psychosocial resource variables in cancer studies: Conceptual and measurement issues (pp. 51–74). Binghamton, NY: Haworth Press.Google Scholar
  28. Johnson, M. O., Elliott, T. R., Neilands, T. B., Morin, S. F., & Chesney, M. A. (2006a). A social problem-solving model of adherence to HIV medications.Health Psychology, 25, 355–363.CrossRefGoogle Scholar
  29. Johnson, M. O., Chesney, M. A., Goldstein, R. B., Remien, R. H., Catz, S., Gore-Felton, C., Charlebois, E., & Morin, S. (2006b). Positive provider interactions, adherence self-efficacy, and adherence to antiretroviral medications among HIV-infected adults: A medication model.AIDS Patient Care, 20, 258–268.CrossRefGoogle Scholar
  30. Kaczorowski, J.M. (1989). Spiritual well-being and anxiety in adults diagnosed with cancer.Hospice Journal, 5, 105–115.PubMedCrossRefGoogle Scholar
  31. Karon, J. M., Fleming, P. L, Steketee, R. W., & De Cock, K. M. (2001). HIV in the United States at the turn of the century.American Journal of Public Health,91, 1060–1068.PubMedCrossRefGoogle Scholar
  32. Kline, P. (1994).An Easy Guide to Factor Analysis. London/New York: Routledge.Google Scholar
  33. Leventhal, H., Benyamini, Y., Brownlee, S., Diefenbach, M., Leventhal, E. A., Patrick-Miller, L., & Robitaille, C. (1997). Illness representations: Theoritical foundations. In K. J. Petrie & J.A. Weinman (Eds.),Perceptions of health and illness: Current research and applications (pp. 19–45). Singapore: Harwood Academic.Google Scholar
  34. Liu, H, Golin, C. E., Miller, L., Hays, R., Beck, K., Sanandaji, S., Christian, J., Maldonado, T., Duran, D., Kaplan, A. H., & Wenger, N. (2001). A comparison of multiple measures of adherence to HIV protease inhibitors.Annals of Internal Medicine,134, 968–977.PubMedGoogle Scholar
  35. Lucas, G.M., Chaisson, R E., & Moore, R. D. (1999). Highly active antiretroviral therapy in a large urban clinic: Risk factors for virologic failure and adverse drug reactions.Annals of Internal Medicine, 131, 81–87.PubMedGoogle Scholar
  36. Marinker, M. (1997). From compliance to concordance: Achieving shared goals in medicine taking.British Medical Journal, 314, 747–748.PubMedGoogle Scholar
  37. Morin, M., Munzenberger, N., Souville, M., Moatti, J.-P., & Gastaut, J. A. (1996).Biases in recruitment and non-compliance in AIDS clinicals trials. XIth International Conference on AIDS, Vancouver, Canada.Google Scholar
  38. Murphy, E. L., Collier, A. C., Kalish, L. A., Assmann, S. F., Para, M. F., Flanigan, T. P., Kumar, P. N, Mintz, L., Wallach, F. R., & Nemo, G. J. (2001). Highly active antiretroviral therapy decreases mortality and morbidity in patients with advanced HIV disease.Annals of Internal Medicine, 135, 17–26.PubMedGoogle Scholar
  39. Newcomb, M. D. (1990). What structural modelling techniques can tell us about social support. In I. G. Sarason, B. R. Sarason, & G. R. Pierce (Eds.),Social support: An interactional view (pp. 26–63). New York: Wiley.Google Scholar
  40. Newcomb, M. D. (1994). Drug use and intimate relationships among women and men: Separating specific from general effects in prospective data using structural equation models.Journal of Consulting and Clinical Psychology, 62, 463–476.PubMedCrossRefGoogle Scholar
  41. Nieuwkerk, P. T., Gisolf, E. H., Reijers, M. H., Lange, J.M., Danner, S. A., & Spranger, M. A. (2001). Long term quality of life outcomes in three antiretroviral treatment strategies for HIV-1 infection.AIDS,15, 1985–1991.Google Scholar
  42. Paterson, D. L., Swindells, S., Mohr, J., Brester, M., Vergis, E. N., & Squier, C. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection.Annals of Internal Medicine, 133, 21–30.PubMedGoogle Scholar
  43. Reynolds, N. R., & Alonzo, A. A. (2000). Self-regulation: The commonsense Model of Illness Representation. In V. H. Rice (Ed.),Handbook of stress and coping (pp. 483–495). Thousand Oaks: Sage.Google Scholar
  44. Reynolds, N. R. (2003). The problem of antiretroviral adherence: A self-regulatory model for intervention.Aids Care, 15, 117–124.PubMedCrossRefGoogle Scholar
  45. Reynolds, N. R., Testa, M. A., Marc, L. G., Chesney, M. A., & Neidig, J. (2004). Factors influencingmedication adherence beliefs and self-efficacy in persons naïve to antiretroviral therapy: Amulticenter, cross-sectional study.Aids Behavior, 8, 141–150.CrossRefGoogle Scholar
  46. Roberts, K. J. (2002). Physician-patient relationships, patient satisfaction, and antiretroviral medication adherence among HIV infected adults attending a public health clinic.AIDS Patient Care and STDs, 16, 43–50.PubMedCrossRefGoogle Scholar
  47. Rokeach, M. (1973).The nature of human values. New York: Free Press.Google Scholar
  48. Roter, D., Rosenbaum, J., de Negri, B., Renaud, D., Diprete-Brown, L., Hernandez, O. (1998). The effect of continuing medical education programme in interpersonal communication skills on doctor practice and patient satisfaction in Trinidad and Tobago.Medical Education, 32(2), 181–189.PubMedCrossRefGoogle Scholar
  49. Royal Pharmaceutical Society of Great Britain. (1997).From compliance to concordance: Achieving shared gaols in medicine taking. London.Google Scholar
  50. Schwartz, S. H. (1992). Universals in the content and the structure of values: Theoretical advances and empirical tests in 20 countries. In M. P. Zanna (Ed.),Advances in experimental social psychology (vol. 25, pp. 1–65). New York: Academic Press.Google Scholar
  51. Simoni, J. M., Frick, P. A., Lockhart, D., & Liebovitz, D. (2002). Mediators of social support and antiretroviral adherence among an indigent population in New York.AIDS Patient Care and STDs, 16, 431–439.PubMedCrossRefGoogle Scholar
  52. Simoni, J. M., Frick, P. A., Pantalone, D.W., & Turner, B. J. (2003). Antiretroviral adherence intervention: A review of current literature and ongoing studies.Topics in HIV Medicine, 11, 185- 198.PubMedGoogle Scholar
  53. Simoni, J. M., Kerwin, J. F., & Martone, M. M. (2002). Spirituality and psychological adaptation among women with HIV/AIDS: Implications for counseling.Journal of Counseling in Psychology, 49, 139–147.CrossRefGoogle Scholar
  54. Simoni, J. M., Frick, P. A., & Huang, B. (2006). A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy.Health Psychology, 25, 74–81.PubMedCrossRefGoogle Scholar
  55. Singh, N., Squier, C., Sivek, C., Wagener, M, Nguyen, M. H., & Yu, V. L. (1996). Determinants of compliance with antiretroviral therapy in patients with human immunodeficiency virus: Prospective assessment with implications for enhancing compliance.AIDS Care, 8, 261–269.PubMedCrossRefGoogle Scholar
  56. Starace, F., Massa, A., & Amico, K. R. (2006). Adherence to antiretroviral therapy: An empirical test of the informationmotivation- behavioral skills model.Health Psychology, 25, 153–162.PubMedCrossRefGoogle Scholar
  57. Tarquinio, C., Fischer, G.-N., Gauchet, A., Dodeler, V., Grégoire, A., & Romary, B. (2003). Compliance et concept de soi chez des patients atteints par le VIH: Une approche dynamique du soi.Revue Internationale de Psychologie Sociale, 16, 21–54.Google Scholar
  58. Tarquinio, C., Fischer, G.-N., & Barracho, C. (2002). Le patient face aux traitements: Compliance et relation médecin-patient. In Fischer, G.-N. (Ed.),Traité de Psychologie de la Santé. Paris: Dunod.Google Scholar
  59. Tarquinio, C., & Fischer, G.-N. (2001). Therapeutic compliance methodologies in HIV infection treatment: A comparative study.Swiss Journal of Psychology, 60, 136–160.CrossRefGoogle Scholar
  60. Tarquinio, C., Fischer, G.-N., & Grégoire, A. (2000). La compliance chez des patients atteints par le VIH: Validation d’une échelle française et mesure de variables psychosociales.Revue Internationale de Psychologie Sociale, 13, 61–91.Google Scholar
  61. Uchino, B. N. (2004).Social support and physical health: Understanding the health consequences of relationships. New Haven, CT: Yale University Press.Google Scholar
  62. Van Vaerenbergh, K., De Geest, S., Derdelinckx, I., Bobbaers, H., Carbonez, A., Deschamps, A., et al. (2002). A combination of poor adherence and a low baseline susceptibility score is highly predictive for HAART failure.Antiviral Chemistry and Chemotherapy, 13, 231–240.PubMedGoogle Scholar
  63. Weaver, K. E., Liabre, M. M., Duran, R. E., Antoni, M. H., Ironson, G., Penedo, F. J., & Schneiderman, N. (2005). A stress and coping model of medication adherence and viral load in HIV-positive men and women on highly active antiretroviral therapy (HAART).Health Psychology, 24, 385–392.PubMedCrossRefGoogle Scholar
  64. Weinman, J., Petrie, K., Moss-Morris, R., & Horne, R. (1996). The illness perception questionnaire: A new method for assessing the cognitive representation of illness.Psychology and Health, 11, 431–445.CrossRefGoogle Scholar
  65. Wright, F. (2000). The role of family care-givers for an older person resident in a care home.British Journal of Social Work, 30(5), 649–661.CrossRefGoogle Scholar
  66. Zinnbauer, B. J., Pargament, K. I., Cole, B., Rye, M. S., Belavich, T. G., & Hipp, K. M. et al. (1997). Religion and spirituality: Unfuzzying the fuzzy.Journal for the Scientific Study of Religion, 36, 549–564.CrossRefGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2007

Authors and Affiliations

  • Aurélie Gauchet
    • 1
  • Cyril Tarquinio
    • 2
  • Gustave Fischer
    • 2
  1. 1.Department of PsychologyUniversity of MiamiCoral Gables
  2. 2.University of MetzFrance

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