Skip to main content

Advertisement

SpringerLink
Log in

Medication adherence in people dually treated for HIV infection and mental health conditions: test of the medications beliefs framework

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

Abstract

Beliefs about medication necessity and concerns predict treatment adherence in people with a wide-array of medical conditions, including HIV infection. However, medication beliefs have not been examined in people dually treated with psychotropic medications and antiretroviral therapy. In the current study, we used a prospective design to investigate the factors associated with adherence to psychotropic medications and antiretrovirals among 123 dually treated persons living with HIV. We used unannounced phone-based pill counts to monitor adherence to psychiatric and antiretroviral medications over a 6-week period. Hierarchical regression models included demographic, health and psychosocial characteristics as predictors of adherence followed by medication necessity and concerns beliefs. Results showed that medication necessity beliefs predicted both antiretroviral and psychiatric medication adherence over and above established predictors of adherence. Medication concerns also predicted psychotropic adherence, but not antiretroviral adherence. These models accounted for 31 and 22 % of the variance in antiretroviral and psychotropic adherence, respectively. Findings suggest that the necessity-concerns medication beliefs framework has utility in understanding adherence to multiple medications and addressing these beliefs should be integrated into adherence interventions.

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

Similar content being viewed by others

References

  • Angelino, A. F., & Treisman, G. J. (2008). Issues in co-morbid severe mental illnesses in HIV infected individuals. International Review of Psychiatry, 20(1), 95–101.

    Article  PubMed  Google Scholar 

  • Bangsberg, D., & Deeks, S. G. (2002). Is average adherence to HIV antiretroviral therapy enough? Journal of General Internal Medicine, 17(10), 812–813.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bangsberg, D. R., Hecht, F. M., Charlebois, E. D., Chesney, M., & Moss, A. (2001). Comparing objective measures of adherence to HIV antiretroviral therapy: Electronic medication monitors and unannounced pill counts. AIDS and Behavior, 5, 275–281.

    Article  Google Scholar 

  • Belenky, N. M., Cole, S. R., Pence, B. W., Itemba, D., Maro, V., & Whetten, K. (2014). Depressive symptoms, HIV medication adherence, and HIV clinical outcomes in Tanzania: a prospective, observational study. PLoS ONE, 9(5), e95469.

  • Brock, D., Sarason, I., Sarason, B., & Pierce, G. (1996). Simultaneous assessment of perceived global and relationship-specific support. Journal of Social and Personal Relationships, 13, 143–152.

    Article  Google Scholar 

  • Carrieri, M. P., Villes, V., Raffi, F., Protpopescu, C., Preau, M., Salmon, D., et al. (2007). Self-reported side-effects of anti-retroviral treatment among IDUs: a 7-year longitudinal study (APROCO-COPILOTE COHORT ANRS CO-8). International Journal of Drug Policy, 18(4), 288–295.

    Article  PubMed  Google Scholar 

  • Chapman, S. C., & Horne, R. (2013). Medication nonadherence and psychiatry. Current Opinion in Psychiatry, 26(5), 446–452.

    Article  PubMed Central  PubMed  Google Scholar 

  • Chesney, M., Folkman, S., & Chambers, D. (1996). Coping effectiveness training for men living with HIV: Preliminary findings. International Journal of STD and AIDS, 7(Suppl 2), 75–82.

    Article  PubMed  Google Scholar 

  • Chitsaz, E., Meyer, J. P., Krishnan, A., Springer, S. A., Marcus, R., Zaller, N., et al. (2013). Contribution of substance use disorders on HIV treatment outcomes and antiretroviral medication adherence among HIV-infected persons entering jail. AIDS and Behavior, 17(Suppl 2), S118–S127.

    Article  PubMed  Google Scholar 

  • Cruess, D. G., Kalichman, S. C., Amaral, C., Swetzes, C., Cherry, C., & Kalichman, M. O. (2012). Benefits of adherence to psychotropic medications on depressive symptoms and antiretroviral medication adherence among men and women living with HIV/AIDS. Annals of Behavioral Medicine, 43(2), 189–197.

    Article  PubMed Central  PubMed  Google Scholar 

  • De Socio, G. V., Fanelli, L., Longo, A., & Stagni, G. (2004). Adherence to antiretroviral therapy in HIV patients with psychiatric comorbidity. Journal of Acquired Immune Deficiency Syndromes, 36(5), 1109–1110.

    Article  PubMed  Google Scholar 

  • Gonzalez, J. S., Penedo, F. J., Llabre, M. M., Duran, R. E., Antoni, M. H., Schneiderman, N., & Horne, R. (2007). Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence. Annals of Behavioral Medicine, 34(1), 46–55.

    Article  PubMed  Google Scholar 

  • Gribble, J. N., Miller, H. G., Cooley, P. C., Catania, J. A., Pollack, L., & Turner, C. F. (2000). The impact of T-ACASI interviewing on reported drug use among men who have sex with men. Substance Use and Misuse, 35(6–8), 869–890.

    Article  CAS  PubMed  Google Scholar 

  • Horne, R. (2011). Adherence to asthma medication: A question of ability? Primary Care in Respiration Journal, 20(2), 118–119.

    Article  Google Scholar 

  • Horne, R., Buick, D., Fisher, 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 and AIDS, 15(1), 38–44.

    Article  PubMed  Google Scholar 

  • Horne, R., Chapman, S. C., Parham, R., Freemantle, N., Forbes, A., & Cooper, V. (2013). Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: A meta-analytic review of the Necessity-Concerns Framework. PLoS ONE, 8(12), e80633.

    Article  PubMed Central  PubMed  Google Scholar 

  • Horne, R., Cooper, V., Gellaitry, G., Date, H. L., & Fisher, M. (2007). Patients’ perceptions of highly active antiretroviral therapy in relation to treatment uptake and adherence: The utility of the necessity-concerns framework. Journal of Acquired Immune Deficiency Syndromes, 45(3), 334–341.

    PubMed  Google Scholar 

  • Horne, R., Parham, R., Driscoll, R., & Robinson, A. (2009). Patients’ attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease. Inflammatory Bowel Disorders, 15(6), 837–844.

    Article  Google Scholar 

  • Huang, Y., Wei, X., Wu, T., Chen, R., & Guo, A. (2013). Collaborative care for patients with depression and diabetes mellitus: A systematic review and meta-analysis. BMC Psychiatry, 13, 260.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Jonsdottir, H., Friis, S., Horne, R., Pettersen, K. I., Reikvam, A., & Andreassen, O. A. (2009). Beliefs about medications: Measurement and relationship to adherence in patients with severe mental disorders. Acta Psychiatrica Scandanavia, 119(1), 78–84.

    Article  CAS  Google Scholar 

  • Kalichman, S. C., Amaral, C. M., Cherry, C., Flanagan, J. A., Pope, H., Eaton, L., et al. (2008). Monitoring Antiretroviral adherence by unannounced pill counts conducted by telephone: Reliability and criterion-related validity. HIV Clinical Trials, 9, 298–308.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kalichman, S. C., Amaral, C. M., Stearns, H. L., White, D., Flanagan, J. A., Pope, H., & Kalichman, M. O. (2007). Adherence to antiretroviral therapy assessed by unannounced pill counts conducted by telephone. Journal of General Internal Medicine, 22, 1003–1006.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kalichman, S., DiMarco, M., Austin, J., Luke, W., & DiFonzo, K. (2003). Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women. Journal of Behavioral Medicine, 26(4), 315–332.

    Article  PubMed  Google Scholar 

  • Kalichman, S., Rompa, D., & Cage, M. (2000). Reliability and validity of self-reported CD4 lymphocyte count and viral load test results in people living with HIV/AIDS. International Journal of STD AIDS, 11(9), 579–585.

    Article  CAS  PubMed  Google Scholar 

  • Lee, S., Rothbard, A. B., Noll, E., & Blank, M. B. (2011). Use of HIV and psychotropic medications among persons with serious mental illness and HIV/AIDS. Administrative Policy Mental Health, 38(5), 335–344.

    Article  Google Scholar 

  • Leserman, J. (2008). Role of depression, stress, and trauma in HIV disease progression. Psychosomatic Medicine, 70(5), 539–545.

    Article  PubMed  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 and STDs, 22(5), 403–411.

    Article  PubMed Central  PubMed  Google Scholar 

  • Maisto, S. A., Conigliaro, J., McNeil, M., Kraemer, K., & Kelley, M. E. (2000). An empirical investigation of the factor structure of the AUDIT. Psychological Assessment, 12(3), 346–353.

    Article  CAS  PubMed  Google Scholar 

  • Mayston, R., Kinyanda, E., Chishinga, N., Prince, M., & Patel, V. (2012). Mental disorder and the outcome of HIV/AIDS in low-income and middle-income countries: A systematic review. AIDS, 26 Suppl 2, S117-135.

  • Morrison-Beedy, D., Carey, M. P., & Tu, X. (2006). Accuracy of audio computer-assisted self-interviewing (ACASI) and self-administered questionnaires for the assessment of sexual behavior. AIDS and Behavior, 10(5), 541–552.

    Article  PubMed Central  PubMed  Google Scholar 

  • Nel, A., & Kagee, A. (2011). Common mental health problems and antiretroviral therapy adherence. AIDS Care, 23(11), 1360–1365.

    Article  PubMed  Google Scholar 

  • Newville, H., Berg, K. M., & Gonzalez, J. S. (2014). The interaction of active substance use, depression, and antiretroviral adherence in methadone maintenance. International Journal of Behavioral Medicine.

  • Saunders, J. B., Aasland, O. G., Babor, T. F., DeLaFuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption II. Addictions, 88(6), 791–804.

    Article  CAS  Google Scholar 

  • Sikkema, K. J., Watt, M. H., Drabkin, A. S., Meade, C. S., Hansen, N. B., & Pence, B. W. (2010). Mental health treatment to reduce HIV transmission risk behavior: A positive prevention model. AIDS and Behavior, 14(2), 252–262.

    Article  PubMed Central  PubMed  Google Scholar 

  • Springer, S. A., Dushaj, A., & Azar, M. M. (2012). The impact of DSM-IV mental disorders on adherence to combination antiretroviral therapy among adult persons living with HIV/AIDS: A systematic review. AIDS and Behavior, 16(8), 2119–2143.

    Article  PubMed Central  PubMed  Google Scholar 

  • Sublette, V. A., Douglas, M. W., McCaffery, K., George, J., & Perry, K. N. (2013). Psychological, lifestyle and social predictors of hepatitis C treatment response: A systematic review. Liver Intervention, 33(6), 894–903.

    Article  Google Scholar 

  • Van Dam, N. T., & Earleywine, M. (2011). Validation of the center for epidemiologic studies depression scale-revised (CESD-R): Pragmatic depression assessment in the general population. Psychiatry Research, 186(1), 128–132.

    Article  PubMed  Google Scholar 

  • Walkup, J., Blank, M. B., Gonzalez, J. S., Safren, S., Schwartz, R., Brown, L., et al. (2008). The impact of mental health and substance abuse factors on HIV prevention and treatment. Journal of Acquired Immune Deficiency Syndromes, 47(Suppl 1), S15–S19.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This project was supported by National Institute of Alcohol Abuse and Alcoholism Grant R01-AA021471 and the National Institute on Drug Abuse Grant R01-DA033067.

Conflict of interest

Seth C. Kalichman, Jennifer Pellowski, Christopher Kegler, Chauncey Cherry, and Moira O. Kalichman declare that they have no conflict of interest.

Human and animal rights and Informed Consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Connecticut, 406 Babbidge Road, Storrs, CT, 06269, USA

    Seth C. Kalichman, Jennifer Pellowski, Christopher Kegler, Chauncey Cherry & Moira O. Kalichman

Authors
  1. Seth C. Kalichman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jennifer Pellowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christopher Kegler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chauncey Cherry
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Moira O. Kalichman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seth C. Kalichman.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kalichman, S.C., Pellowski, J., Kegler, C. et al. Medication adherence in people dually treated for HIV infection and mental health conditions: test of the medications beliefs framework. J Behav Med 38, 632–641 (2015). https://doi.org/10.1007/s10865-015-9633-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-015-9633-6

Keywords

Search

Navigation