Top

Published in:

01-03-2007 | Original Paper

Factors Associated with Suboptimal Antiretroviral Therapy Adherence to Dose, Schedule, and Dietary Instructions

Authors: Lena Nilsson Schönnesson, Mark L. Williams, Michael W. Ross, Göran Bratt, Blair Keel

Published in: AIDS and Behavior | Issue 2/2007

Abstract

The purpose of this study was to assess the degree of suboptimal antiretroviral therapy adherence to dose, schedule, and dietary instructions and to examine the effects of extra-personal, intra-personal, and inter-personal factors on suboptimal adherence across the three types of instructions. Self-report and clinical data were collected from 193 sexually infected Swedish patients receiving ART. Effects of extra-personal, intra-personal, and inter-personal factors on suboptimal adherence were examined using multivariate logistic regression models. Suboptimal adherence to dose instructions was recorded in 12% of patients. Equivalent percentage for suboptimal adherence to schedule instructions was 37% and for suboptimal adherence to dietary instructions 58%. Anxiety was the only risk factor for suboptimal adherence to dose. Heavy pill burden was a risk factor for suboptimal adherence to schedule. Older age and HIV-related post-traumatic stress disorder (PTSD) symptoms decreased the risk of suboptimal adherence to schedule. No factors investigated had an effect on suboptimal adherence to dietary instructions. To improve adherence to dose and schedule instructions, clinicians caring for patients with HIV should assess and treat anxiety and be alert to HIV-related PTSD symptoms.

Altice, F. L., Mostashari, F., & Friedland, G. H. (2001). Trust and acceptance of and adherence to antiretroviral therapy. Journal of Acquired Immune Deficiency Syndrome, 28, 47–58.

Ammassari, A., Murri, R., Pezzotti, P., Trotta, M. P., 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 Syndrome, 28, 445–449.

Ammassari, A., Trotta, M. P., Murri, R., Castelli, F., Narcisco, P., Noto, P., et al. (2002). Correlates and predictors of adherence to highly active antiretroviral therapy: Overview of published literature. Journal of Acquired Immune Deficiency Syndrome, 31(Suppl. 3), S123–S127.

Bartlett, J. A. (2002). Addressing the challenges of adherence. Journal of Acquired Immune Deficiency Syndrome, 29(Suppl. 3), S2–S10.

Bartlett, J. A., DeMasi, R., & Quinn, J. (2001). Overview of the effectiveness of triple combination therapy in antiretroviral-naive HIV-1 infected adults. AIDS, 15, 1369–1377.PubMedCrossRef

Beck, A., Weissman, A., Lester, D., & Trezler, L. (1974). The measurement of pessimism: The Hopelessness scale. Journal of Consulting and Clinical Psychology, 42, 861–865.PubMedCrossRef

Begley, K. (2004). A behavioral model of protease inhibitor non-adherence: theoretical and clinical implications. Thesis. School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales.

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

Cederfjäll C. (2002). Aspects of care among HIV-infected patients. Needs, adherence to treatment and health related quality of life. Stockholm, Sweden: Dissertation, Karolinska Institute.

Chesney, M. A., Ickovics, J. R., Chambers, D. B., Gifford, A. 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.PubMedCrossRef

Delahanty, D. L., Bogart, L. M., & Figler, J. L. (2004). Posttraumatic stress disorder symptoms, salivary cortisol, medication adherence, and CD4 levels in HIV-positive individuals. AIDS Care, 16, 47–260.CrossRef

Derogatis, I., & Melisatanos, N. (1983). The brief symptom inventory: An introductory report. Psychological Medicine, 13, 595–605.PubMedCrossRef

Duran, S., Spire, B., Raffi, F., Walter, V., Bouhour, D., Journot, V., et al. (2001). Self-reported symptoms after initiation of a protease inhibitor in HIV-infected patients and their impact on adherence to HAART. HIV Clinical Trials, 2, 38–45.PubMedCrossRef

Eldred, L. J., Wu, A. W., Chaisson, R. E., & Moore, R. D. (1998). Adherence to antiretroviral and Pneumocystis prophylaxis in HIV disease. Journal of Acquired Immune Deficiency Syndrome, 18, 117–125.

Gao, X., Nau, D. P., Rosenbluth, S. A., Scott, V., & Woodward, C. (2000). The relationship of disease severity, health beliefs and medication adherence among HIV patients. AIDS Care, 12, 387–398.PubMedCrossRef

Gifford, A., Borman, J., Shivley, M., Wright, B. C., Richman, D. D., & Bozette, S. A. (2000). Predictors of self-reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens. Journal of Acquired Immune Deficiency Syndrome, 23, 386–395.

Godin, G., Coté, J., Naccache, H., Lambert, L. D., & Trottier, S. (2005). Prediction of adherence to antiretroviral therapy: A one-year longitudinal study. AIDS Care, 17, 493–504.PubMed

Gordillo, V., del Amo, J., Soriano, V., & Gonzalez-Lahoz, J. (1999). Sociodemographic and psychological variables influencing adherence to antiretroviral therapy. AIDS, 13, 1763–1769.PubMedCrossRef

Horowitz, M. J., Wilner, N. R., & Alvarez, W. (1979). Impact of event scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209–218.PubMed

Ingersoll, K. (2004). The impact of psychiatric symptoms, drug use, and medication regimen on non-adherence to HIV treatment. AIDS Care, 16, 199–211.PubMedCrossRef

Jensen-Fangel, S., Pedersen, L., Pedersen, C., Larsen, C. S, Tauris, P., Moller, A., et al. (2002). The effect of race/ethnicity on the outcome of highly active antiretroviral therapy for human immunodeficiency virus type 1–infected patients. Clinical Infectious Diseases, 35, 1541–1548.PubMedCrossRef

Kelly, B., Raphael, B., Judd, F., Kernutt, G., Burnett, P., Dunne, M., et al. (1998). Posttraumatic stress disorder in response to HIV infection. General Hospital Psychiatry, 20, 345–352.PubMedCrossRef

Kleeberger, C. A., Phair, J. P., Strathdee, S. A., Detels, R., Kingsley, L., & Jacobson, L. P. (2001). Determinants of heterogeneous adherence to HIV-antiretroviral therapies in the Multicenter AIDS cohort study. Journal of Acquired Immune Deficiency Syndrome, 26, 82–92.

Liu, H., Miller, L. G., Hays, R. D., Golin, C. E., Wu, T., Wenger, N. S., et al. (2006). Repeated measures longitudinal analyses of HIV virologic response as a function of percent adherence, dose timing, genotypic sensitivity, and other factors. Journal of Acquired Immune Deficiency Syndrome, 41, 315–322.CrossRef

Mannheimer, S., Friedland, G., Matts, J., Child, C., & Chesney, M. (2002). The consistency of adherence to antiretroviral therapy predicts biologic outcomes for human immunodeficiency virus-infected persons in clinical trials. Clinical Infectious Diseases, 34, 1115–1121.PubMedCrossRef

Molassiotis, A., Nahas-Lopez, V., Chung, R. W. Y., Lam, C. S. W., Li, P. C. K., & Lau, J. T. F. (2002). Factors associated with adherence to antiretroviral medication in HIV-infected patients. International Journal of STD & AIDS, 13, 301–310.CrossRef

Murphy, D. A., Marelich, D., Hoffman, D., & Steers, W. N. (2004). Predictors of antiretroviral adherence. AIDS Care, 16, 471–484.PubMedCrossRef

Murri, R., Ammassari, A., Gallicano, K., de Luca, A., Cingolani, A., Jacobson, D., et al. (2000). Patient-reported nonadherence to HAART is related to protease inhibitor levels. Journal of Acquired Immune Deficiency Syndrome, 24, 123–128.

Nieuwkerk, P. T., Sprangers, M. A. G., Burger, D. M., Hoetelmans, R. M. W., Hugen, P. W. H., Danner, S. A., et al. (2001). Limited patient adherence to highly active antiretroviral therapy for HIV-1 infection in an observational cohort study. Archives of Internal Medicine, 16, 1962–1968.CrossRef

Nilsson Schönnesson, L., Diamond, P. M., Ross, M. W., Williams, M., & Bratt, G. (2006). Baseline predictors of three types of antiretroviral therapy (ART) adherence: A 2-year follow-up. AIDS Care, 18, 406–414.CrossRef

Nilsson Schönnesson, L., Ross, M. W., & Williams, M. (2004). The HIV medication self-reported non-adherence reasons (SNAR) index and its underlying psychological dimensions. AIDS and Behavior, 8, 293–301.CrossRef

Paterson, D. L., Swindells, S., Mohr, J., Brester, M., Vergis, E. N., Squier, C., et al. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annual Internal Medicine, 133, 21–30.

Poppa, A., Davidson, D., Deutsch, J., Godfrey, D., Fisher, M., Head, S., et al. (2004). British HIV Association (BHIVA)/British Association for sexual health and HIV (N`BASHH) guidelines on provision of adherence support to individuals receiving antiretroviral therapy (2003). HIV Medicine, 5(Suppl. 2), S46–S60.CrossRef

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 City. AIDS Patient Care and STDs, 16, 431–429.PubMedCrossRef

Singh, N., Squier, C., Sivek, M., Wagener, M., Nguyen, M. H., & Yu, V. L. (1996). Determinants of compliance with antiretroviral therapy in patients with human immunodefiency virus: Prospective assessment with implications for enhancing compliance. AIDS Care, 8, 261–269.PubMedCrossRef

Stone, V. E., Hogam, J. W., Schuman, P., Rompalo, A. M., Howard, A. A., Korkontzelou, C., et al. (2001). Antiretroviral regimen complexity, self-reported adherence, and HIV-patients’ understanding of their regimens: Survey of women in the HER study. Journal of Acquired Immune Deficiency Syndrome, 28, 124–31.CrossRef

Sundin, E. C., & Horowitz, M. J. (2002). Impact of event scale: Psychometric properties. British Journal of Psychiatry, 180, 205–209.PubMedCrossRef

Turner, B. J. (2002). Adherence to antiretroviral therapy by human immunodeficiency virus-infected patients. Journal of Infectious Disease, 185(Suppl. 2), S143–S151.CrossRef

Walsh, J. C., Horne, R., & Dalton, M. (2001). Reasons for non-adherence to antiretroviral therapy: Patients’ perspectives provide evidence of multiple causes. AIDS Care, 13, 709–720.PubMedCrossRef

Title: Factors Associated with Suboptimal Antiretroviral Therapy Adherence to Dose, Schedule, and Dietary Instructions
Authors: Lena Nilsson Schönnesson
Mark L. Williams
Michael W. Ross
Göran Bratt
Blair Keel
Publication date: 01-03-2007
Publisher: Springer US
Published in: AIDS and Behavior / Issue 2/2007
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-006-9160-0

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Factors Associated with Suboptimal Antiretroviral Therapy Adherence to Dose, Schedule, and Dietary Instructions

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2007

Correlates of HIV Risk and Preventive Behaviors in Armenian Female Sex Workers

Awareness and Attitudes Regarding Microbicides and Nonoxynol-9 use in a Probability Sample of Gay Men

Prevalence of HIV, Hepatitis B, Syphilis, and Chlamydia Among Adults Seeking Treatment for a Mental Disorder in Southern India

Recruitment Source and Behavioral Risk Patterns of HIV-Positive Men Who have Sex with Men

Alcohol Consumption, Art Usage and High-Risk Sex Among Women Infected with HIV

Intentional Unprotected Anal Intercourse among Sex Who have Sex with Men: Barebacking—from Behavior to Identity

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page