Skip to main content

Advertisement

SpringerLink
Log in

A longitudinal investigation of the impact of life stress on HIV treatment adherence

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Suboptimal antiretroviral adherence is associated with poorer HIV outcomes. Psychosocial factors, including life stress, depression and coping, may influence adherence behavior. This prospective investigation sought to examine the impact of life stress (acute life events, chronic stress, and perceived stress), depression, and coping style on adherence to HIV treatment regimes over time. Participants were 87 treatment-seeking HIV-infected individuals recruited from an urban HIV clinic. They completed clinician-administered interviews and self-report questionnaires at baseline and 3-month follow-up. Acute life events and chronic stress prospectively predicted decreases in treatment adherence more strongly among individuals in a major depressive episode (n = 21) compared to non-depressed individuals (n = 66). Coping style did not appear to be the mechanism by which life stress influenced adherence among depressed HIV-infected individuals. These findings demonstrate that life stress has toxic effects for depressed individuals and suggest that treatment adherence interventions with depressed individuals could be enhanced via development of stress management skills.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.

    Google Scholar 

  • Ammassari, A., Antinori, A., Aloisi, M. S., Trotta, M. P., Murri, R., Bartoli, L., et al. (2004). Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons. Psychosomatics, 45, 394–402.

    Article  PubMed  Google Scholar 

  • Barron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Article  Google Scholar 

  • Bilfulco, A., Brown, G., Edwards, A., Harris, T., Neilson, E., Richards, C., et al. (1989). Life events and difficulties schedule (LEDS-2): Volume 1. Life events manual. London: Royal Halloway and Bedford College, University of London.

    Google Scholar 

  • Bottonari, K. A., Roberts, J. E., Ciesla, J. A., & Hewitt, R. G. (2005). Life stress and adherence to antiretroviral therapy among HIV + individuals: A preliminary investigation. AIDS Patient Care & STDs, 19, 17–25.

    Article  Google Scholar 

  • Bottonari, K. A., Roberts, J. E., Kelly, M. A. R., Kashdan, T. B., & Ciesla, J. A. (2007). A prospective investigation of the impact of attachment style on stress generation among clinically depressed individuals. Behavior Research &Therapy, 45, 179–188.

    Article  Google Scholar 

  • Box, G. E. P., & Cox, D. R. (1964). An analysis of transformations. Journal of the Royal Statistical Society: Series B, 26, 211–252.

    Google Scholar 

  • Brown, G. W., & Harris, T. O. (1978). Social origins of depression: A study of psychiatric disorder in women. New York: Free Press.

    Google Scholar 

  • Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92–100.

    Article  CAS  PubMed  Google Scholar 

  • Catz, S. L., Heckman, T. G., Kochman, A., & DiMarco, M. (2001). Rates and correlates of HIV treatment adherence among late middle-aged and older adults living with HIV disease. Psychology, Health, & Medicine, 6, 47–58.

    Article  Google Scholar 

  • Catz, S. L., Kelly, J. A., Bogart, L. M., Benotsch, E. G., & McAuliffe, T. L. (2000). Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychology, 19, 124–133.

    Article  CAS  PubMed  Google Scholar 

  • Chesney, M. A., Ickovics, J. R., Chambers, D. B., Gifford, N. L., Neidig, J., Zwickl, B., et al. (2000). Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The AACTG Adherence Instruments. AIDS Care, 12, 255–266.

    Article  CAS  PubMed  Google Scholar 

  • Ciesla, J. A., & Roberts, J. E. (2001). Meta-analysis of the relationship between HIV infection and risk for depressive disorders. American Journal of Psychiatry, 158, 725–730.

    Article  CAS  PubMed  Google Scholar 

  • Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.

    Article  CAS  PubMed  Google Scholar 

  • Cohen, S., & Williamson, G. R. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health: Claremont symposium on applied social psychology. Newbury Park, CA: Sage.

    Google Scholar 

  • Coyne, J. (1994). Self-reported distress: Analog or ersatz depression? Psychological Bulletin, 116, 29–45.

    Article  CAS  PubMed  Google Scholar 

  • Crepaz, N., Passin, W. F., Herbst, J. H., Rama, S. M., Malow, R. M., Purcell, D. W., et al. (2008). Meta-analysis of cognitive-behavioral interventions on HIV-positive persons’ mental health and immune functioning. Health Psychology, 27, 4–14.

    Article  PubMed  Google Scholar 

  • Davis, T. C., Long, S. W., Jackson, R. H., Mayeaux, E. J., George, R. B., Murphy, P. W., et al. (1993). Rapid estimate of adult literacy in medicine: A shorthand screening instrument. Family Medicine, 25, 391–395.

    CAS  PubMed  Google Scholar 

  • Deschamps, N. E., Graeve, V. D., van Wijngaerden, E., De Saar, V., Vandamme, N. M., van Vaerenbergh, K., et al. (2004). Prevalence and correlates of nonadherence to antiretroviral therapy in a population of HIV patients using medication event monitoring system. AIDS Patient Care & STDS, 18, 644–657.

    Article  Google Scholar 

  • Fechner-Bates, S., Coyne, J. C., & Schwenk, T. L. (1994). The relationship of self-reported distress to psychopathology. Journal of Consulting and Clinical Psychology, 62, 550–559.

    Article  CAS  PubMed  Google Scholar 

  • Folkman, S., & Moskowitz, J. T. (2004). Coping: pitfalls and promise. Annual Review of Psychology, 55, 745–774.

    Article  PubMed  Google Scholar 

  • French, T., Weiss, L., Waters, M., Tersoriero, J., Finkelstein, R., & Agins, B. (2005). Correlation of a brief perceived stress measure with nonadherence to antiretroviral therapy over time. Journal of Acquired Immune Deficiency Syndromes, 38, 590–597.

    Article  PubMed  Google Scholar 

  • Gifford, N. L., & Groessl, E. J. (2002). Chronic disease self-management and adherence to HIV medications. Journal of Acquired Immune Deficiency Syndromes, 31, S163–S166.

    PubMed  Google Scholar 

  • Gonzalez, J. S., Penedo, F. J., Antoni, M. H., Durán, R. E., McPherson-Baker, S., Ironson, G., et al. (2004). Social support, positive states of mind, and HIV treatment adherence in men and women living with HIV/AIDS. Health Psychology, 23, 413–418.

    Article  PubMed  Google Scholar 

  • Gore-Felton, C., & Koopman, C. (2002). Traumatic experiences: Harbinger of risk behavior among HIV-positive adults. Journal of Trauma & Dissociation, 3, 121–135.

    Article  Google Scholar 

  • Hammen, C. L., Adrian, C., Gordon, D., Jaenicke, C., & Hiroto, D. (1987). Children of depressed mothers: Maternal strain and symptom predictors of dysfunction. Journal of Abnormal Psychology, 96, 190–198.

    Article  CAS  PubMed  Google Scholar 

  • Jia, H., Uphold, C., Wu, S., Reid, K., Findley, K., & Duncan, P. (2004). Health-related quality of life among men with HIV infection: Effects of social support, coping, and depression. AIDS Patient Care & STDs, 18, 594–603.

    Article  Google Scholar 

  • Komiti, A., Judd, F., Grech, P., Mijch, A., Hoy, J., Williams, B., et al. (2003). Depression in people living with HIV/AIDS attending primary care and outpatient clinics. Australian and New Zealand Journal of Psychiatry, 37, 70–77.

    Article  PubMed  Google Scholar 

  • Koopman, C., Gore-Felton, C., Marouf, F., Butler, L. D., Field, N., Gill, M., et al. (2000). Relationships of perceived stress to coping, attachment and social support among HIV-positive persons. AIDS Care, 12, 663–672.

    Article  CAS  PubMed  Google Scholar 

  • Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer Publishing.

    Google Scholar 

  • Lecrubier, Y., Sheehan, D., Weiller, E., Amorim, P., Bonora, I., Sheehan, K., et al. (1997). The MINI International Neuropsychiatric Interview (M.I.N.I.) a short diagnostic structured interview: Reliability and validity according to the CIDI. European Psychiatry, 12, 224–231.

    Article  Google Scholar 

  • Leserman, J., Ironson, G., O’Cleirigh, C., Fordiani, J. M., & Balbin, E. (2008). Stressful life events and adherence in HIV. AIDS Patient Care & STDS, 22, 403–411.

    Article  Google Scholar 

  • Lima, V. D., Geller, J., Bangsberg, D. R., Patterson, T. L., Daniel, M., Kerr, T., et al. (2007). The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating HAART. AIDS, 21, 1175–1183.

    Article  PubMed  Google Scholar 

  • Liu, C., Weber, K., Robison, E., Hu, Z., Jacobson, L. P., & Gange, S. J. (2006). Assessing the effect of HAART on change in quality of life among HIV-infected women. AIDS Research and Human Retroviruses, 3, 6–16.

    Google Scholar 

  • Lu, M., Safren, S. A., Skolnik, P. R., Rogers, W. H., Coady, W., Hardy, H., et al. (2008). Optimal recall period and response task for self-reported HIV medication adherence. AIDS and Behavior, 12, 86–94.

    Article  PubMed  Google Scholar 

  • Lucas, G. M. (2005). Antiretroviral adherence, drug resistance, viral fitness, and HIV disease progression: A triangle web is woven. Journal of Antimicrobial Chemotherapy, 55, 413–416.

    Article  CAS  PubMed  Google Scholar 

  • McQuaid, J., Monroe, S. M., Roberts, J. E., Kupfer, D. J., & Frank, E. (2000). A comparison of two life stress assessment approaches: Prospective prediction of treatment outcome in recurrent depression. Journal of Abnormal Psychology, 109, 787–791.

    Article  CAS  PubMed  Google Scholar 

  • Mellins, C. A., Kang, E., Leu, C., Havens, J. F., & Chesney, M. A. (2003). Longitudinal study of mental health and psychosocial predictors of medical treatment adherence in mothers living with HIV Disease. AIDS Patient Care & STDs, 17, 407–416.

    Article  Google Scholar 

  • Mimiaga, M. J., Raisner, S., Reilly, L. C., Soroudi, N., & Safren, S. A. (2008). Individual interventions. In K. H. Mayer & H. Pizer (Eds.), HIV-prevention (pp. 203–239). NY: Academic Press.

    Google Scholar 

  • Monroe, S. M., & Roberts, J. E. (1990). Conceptualizing and measuring life stress: Problems, principles, procedures, progress. Stress Medicine, 6, 209–216.

    Article  Google Scholar 

  • Montgomery, S. A., & Asberg, M. (1979). A new depression rating scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.

    Article  CAS  PubMed  Google Scholar 

  • Murphy, D. A., Greenwell, L., & Hoffman, D. (2002). Factors associated with antiretroviral adherence among HIV-infected women with children. Women and Health, 36, 97–111.

    Article  Google Scholar 

  • R Development Core Team. (2009). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, URL http://www.R-project.org.

  • Rabkin, J. G. (2008). HIV and depression: 2008 review and update. Current HIV/AIDS Reports, 5, 163–171.

    Article  PubMed  Google Scholar 

  • Roberts, J. E., Ciesla, J. A., Direnfeld, D. M., & Hewitt, R. G. (2001). Emotional distress among HIV-positive individuals: The roles of acute negative life events and psychological diatheses. Personality and Individual Differences, 30, 241–257.

    Article  Google Scholar 

  • Ruscio, J., Brown, T. A., & Ruscio, N. M. (2009). A taxometric investigation of DSM-IV major depression in a large outpatient sample: Interpretable structural results depend on the mode of assessment. Assessment, 16, 127–144.

    Article  PubMed  Google Scholar 

  • Ruscio, J., Zimmerman, M., McGlinchey, J. B., Chelminski, I., & Young, D. (2007). Diagnosing major depressive disorder: XI. A taxometric investigation of the categorical/dimensional debate on the structure underlying DSM-IV symptoms. Journal of Nervous & Mental Disorders, 195, 10–19.

    Article  Google Scholar 

  • Safren, S. A., O’Cleirigh, C., Tan, J. Y., Raminani, S. R., Reilly, L. C., Otto, M. W., et al. (2009). A randomized controlled trial of cognitive behavioral therapy for adherence and depression (CBT-AD) in HIV-infected individuals. Health Psychology, 28, 1–10.

    Article  PubMed  Google Scholar 

  • Safren, S. A., Otto, M. W., Worth, J. L., Salomon, E., Johnson, W., Mayer, K., et al. (2001). Two strategies to increase adherence to HIV antiretroviral medication: Life-steps and medication monitoring. Behavior Research & Therapy, 39, 1151–1162.

    Article  CAS  Google Scholar 

  • Safren, S. A., Radomsky, N. S., Otto, M. W., & Salomon, E. (2002). Predictors of psychological well-being in a diverse sample of HIV-positive patients receiving highly active antiretroviral therapy. Psychosomatics, 43, 478–485.

    Article  PubMed  Google Scholar 

  • Sheehan, D. V., Lecrubier, Y., Harnett-Sheehan, K., Janavs, J., Weiller, E., Bonora, L. I., et al. (1997). Reliability and validity of the MINI International Neuropsychiatric Interview (M.I.N.I.): According to the SCID-P. European Psychiatry, 12, 232–241.

    Article  Google Scholar 

  • Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The mini-international neuropsychiatric interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.

    PubMed  Google Scholar 

  • Simoni, J., Kurth, A., Pearson, C., Pantalone, D., Merrill, J., & Frick, P. (2006a). Self-report measures of antiretroviral therapy adherence: A review with recommendations for HIV research and clinical management. AIDS and Behavior, 10, 227–245.

    Article  PubMed  Google Scholar 

  • Simoni, J. M., Pearson, C. R., Pantalone, D. W., Marks, G., & Crepaz, N. (2006b). Efficacy of interventions in improving highly active antiretroviral therapy adherence and HIV-1 RNA viral load. Journal of Acquired Immune Deficiency Syndromes, 43, S23–S35.

    Article  PubMed  Google Scholar 

  • Weaver, K. E., Llabre, M. M., Duran, R. E., Antoni, M. H., Ironson, G., Penedo, F. J., et al. (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.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Charlie Norwood VA Medical Center, 1 Freedom Way (261), Augusta, GA, 30904, USA

    Kathryn A. Bottonari

  2. Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA

    Steven A. Safren

  3. San Francisco VA Medical Center, University of California San Francisco, San Francisco, CA, USA

    John R. McQuaid

  4. Department of Medicine, University at Buffalo: State University of New York, Buffalo, NY, USA

    Chiu-Bin Hsiao

  5. Department of Psychology, University at Buffalo: State University of New York, Buffalo, NY, USA

    John E. Roberts

Authors
  1. Kathryn A. Bottonari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steven A. Safren
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John R. McQuaid
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chiu-Bin Hsiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John E. Roberts
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kathryn A. Bottonari.

Additional information

This research was conducted at the University at Buffalo: State University of New York as part of the first author’s dissertation. This research was supported in part by a National Research Service Award from the Office of AIDS, National Institute of Mental Health (F31MH072551) to Kathryn A. Bottonari and John E. Roberts. We thank Christine A. Calmes, James J. Prisciandaro, Erica L. Carlos, and Paula K. Yanes, who participated in rating of the life events and reliability analyses.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bottonari, K.A., Safren, S.A., McQuaid, J.R. et al. A longitudinal investigation of the impact of life stress on HIV treatment adherence. J Behav Med 33, 486–495 (2010). https://doi.org/10.1007/s10865-010-9273-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-010-9273-9

Keywords

Search

Navigation