Journal of Religion and Health

, Volume 56, Issue 6, pp 2144–2161 | Cite as

Examination of the Role of Religious and Psychosocial Factors in HIV Medication Adherence Rates

  • Safiya George DalmidaEmail author
  • Katryna McCoy
  • Harold G. Koenig
  • Aretha Miller
  • Marcia McDonnell Holstad
  • Tami Thomas
  • Dora Clayton-Jones
  • Mary Grant
  • Terri Fleming
  • Menka Munira Wirani
  • George Mugoya
Original Paper


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).


HIV/AIDS Medication adherence Religion Spirituality Antiretroviral therapy 



This research was supported by a grant from The John Templeton Foundation supporting Dr. George Dalmida’s postdoctoral fellowship in Religion and Health research at Duke University.

Compliance with Ethical Standards

Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the University and University Medical Center Institutional Research Boards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Safiya George Dalmida
    • 1
    Email author
  • Katryna McCoy
    • 2
  • Harold G. Koenig
    • 3
    • 4
  • Aretha Miller
    • 5
  • Marcia McDonnell Holstad
    • 6
  • Tami Thomas
    • 7
  • Dora Clayton-Jones
    • 8
  • Mary Grant
    • 9
  • Terri Fleming
    • 6
  • Menka Munira Wirani
    • 6
  • George Mugoya
    • 10
  1. 1.Capstone College of NursingThe University of AlabamaTuscaloosaUSA
  2. 2.School of Nursing and Health StudiesUniversity of WashingtonBothellUSA
  3. 3.Department of PsychiatryDuke University Medical CenterDurhamUSA
  4. 4.Department of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
  5. 5.College of Health SciencesWalden UniversityMinneapolisUSA
  6. 6.Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaUSA
  7. 7.Nicole Werthiem College of Nursing and Health SciencesFlorida International UniversityMiamiUSA
  8. 8.College of NursingUniversity of Wisconsin-MilwaukeeMilwaukeeUSA
  9. 9.Duke UniversityDurhamUSA
  10. 10.College of EducationThe University of AlabamaTuscaloosaUSA

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