Mind Matters: Treatment Concerns Predict the Emergence of Antiretroviral Therapy Side Effects in People with HIV

Rob Horne,Sarah Chapman,Elizabeth Glendinning,Vanessa Cooper,Heather Leake Date,Jordi Guitart

doi:10.1007/s10461-018-2239-6

Rob Horne, Sarah Chapman + Show 4 more

Open Access

https://doi.org/10.1007/s10461-018-2239-6

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Abstract

The aim of this analysis of historical data was to determine whether patients’ pre-treatment beliefs about antiretroviral therapy (ART) predict the subsequent reporting of side effects. Data were collected as part of a prospective, 12-month follow-up study. Of 120 people starting ART, 76 completed follow-up assessments and were included in the analyses. Participants completed validated questionnaires assessing their beliefs about ART, beliefs about medicines in general, perceived sensitivity to adverse effects of medicines, depression and anxiety before initiating ART and after 1 and 6 months of treatment. Adherence was assessed at 1, 6 and 12 months. Pre-treatment concerns about ART were associated with significantly more side effects at 1 month (p < 0.05) and 6 months (p < 0.005). Side effects at 6 months predicted low adherence at 12 months (p < 0.005). These findings have implications for the development of interventions to support patients initiating ART by providing a mechanism to pre-empt and reduce side effects.

Highlights

Antiretroviral therapy (ART) extends life expectancy, improves quality of life and prevents transmission of HIV [1,2,3]
Since specific medication concerns are often related to more general beliefs about pharmaceuticals and perceptions of personal sensitivity to the effects of medicines, we explored whether patients’ beliefs about medicines in general and perceived sensitivity to medicines were associated with concerns about antiretroviral therapy (ART)
A further 22 participants enrolled in the study initially declined a treatment recommendation but initiated treatment over the 1 year follow-up

Summary

Introduction

Antiretroviral therapy (ART) extends life expectancy, improves quality of life and prevents transmission of HIV [1,2,3]. Not all side effects can be directly attributed to the pharmacological action of the drug. Many patients experience side effects when taking placebo [8], indicating that side effects can be caused by factors other than the drug itself. These negative, nonspecific effects of a drug are described as nocebo responses [9]. Factors such as verbal suggestion and negative treatment experiences can induce side effects in people taking both placebos and active drug treatment [10, 11]. A better understanding of the determinants of side effects of ART could help healthcare professionals to identify patients who are at risk of developing side effects and offer appropriate support

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Conclusion