Journal of Behavioral Medicine

, Volume 42, Issue 3, pp 392–400 | Cite as

Perceived sensitivity to medicines, alcohol interactive toxicity beliefs, and medication adherence among people living with HIV who drink alcohol

  • Seth C. KalichmanEmail author
  • Rob Horne
  • Harold Katner
  • Dominica Hernandez


Erroneous beliefs that it is toxic to drink alcohol while taking antiretroviral therapies (ART) used for treating HIV infection, known as alcohol interactive toxicity beliefs, may at least in part account for ART nonadherence among alcohol drinkers. This study was conducted to test a conceptual framework to explain the effects of interactive toxicity beliefs on ART adherence. Computerized surveys were administered to 124 participants receiving HIV care in the southeastern US. Serial mediation model with perceived sensitivity to medicines predicting HIV viral load through three mediating variables: alcohol-ART interactive toxicity beliefs, alcohol-ART avoidance behaviors, and ART adherence. HIV viral load extracted from medical records. Perceived sensitivity to medicines predicted HIV viral load; greater perceptions of medication sensitivity predicted lower HIV viral loads. In addition, there was a significant indirect effect of the serial chain of interactive toxicity beliefs → avoidance behaviors → ART adherence, indicating partial mediation of the relationship between perceived sensitivity to medicines and higher HIV viral load. Perceived sensitivity to medicines provides a conceptual basis for the effects of alcohol-medication interactive toxicity beliefs on ART adherence. Interactive toxicity beliefs are modifiable and can be altered to prevent intentional ART nonadherence.


Adherence Perceived medication sensitivity Pharmaceutical schema Alcohol use 



This project was supported by National Institute of Alcohol Abuse and Alcoholism Grant R01-AA023727.

Compliance with ethical standards

Conflict of interest

Seth C. Kalichman, Rob Horne, Harold Katner, and Dominica Hernandez declare that they have no conflicts of interest.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research ethics committee (IRB) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all participants included in this study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Seth C. Kalichman
    • 1
    Email author
  • Rob Horne
    • 2
  • Harold Katner
    • 3
  • Dominica Hernandez
    • 1
  1. 1.Institute for Collaboration on Health Intervention and PolicyUniversity of ConnecticutStorrsUSA
  2. 2.University College LondonLondonUK
  3. 3.Department of MedicineMercer University Medical SchoolMaconUSA

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