Antiretroviral Therapy In People Research Articles

Is the use of CAM associated with a greater self‐reported adherence to antiretroviral therapy in people with HIV disease?

Is the use of CAM associated with a greater self‐reported adherence to antiretroviral therapy in people with HIV disease?

Factors Affecting Adherence to Antiretroviral Therapy in People Living with HIV/AIDS

Antiretroviral treatments have given hope to people living with HIV/AIDS and play a role in improving their quality of life. However, the effectiveness of these treatments is directly related to the level of adherence and commitment to them. Researchers have demonstrated that there are many factors that play an important role in adopting and maintaining adherence behavior. In this article, the authors present an indepth review of the literature and from this, enumerate the factors that link adherence behavior to the individual, the treatment, the illness, and the relationship with the health professional. An understanding of these factors is essential to develop interventions that will improve adherence to therapeutic regimens among people with HIV/AIDS.

Interventions to improve adherence to antiretroviral therapy.

Recent research has shown that very high levels of adherence are required to obtain the maximum benefit of highly active antiretroviral therapy (HAART). This situation justifies the importance of developing efficient strategies to improve adherence to drugs against HIV. A comprehensive range of factors are the targets of the most effective interventions to improve adherence, including cognitive, behavioral, emotional, and social aspects. The authors describe three theoretical models that can help identify barriers and guide interventions. Most of the interventions are complex and may include more convenient care, provision of information, counseling, reminders, reinforcement, self-monitoring, family therapy, or additional supervision or attention. The authors suggest aspects that should be included in interventions to promote adherence based on a review of the literature and clinical experience. Limited evidence suggests that interventions to enhance adherence to antiretroviral therapy in people with HIV are most likely to be successful when they are comprehensive, longitudinal, and tailored to the person.

Adherence to Antiretroviral Therapy: Appropriate Use of Self-Reporting in Clinical Practice

Purpose: This study investigated the factors that may affect adherence to antiretroviral therapy in people with HIV infection and compared the use of three self-report tools to determine client adherence. Method: A descriptive, cross-sectional study of 260 HIV-infected clients attending nine HIV outpatient centers in England was conducted using researcher-administered instruments. Self-reports of adherence were assessed using the Morisky Medication Adherence Scale (MMAS), Reported Adherence to Medication Scale (RAM), and the Patient Adjustment to Medication Scale (PAM). Results: Univariate analysis of clients’ self-reports indicated a number of associations with adherence. Significant associations with less adherent behavior identified by two or more self-report tools were the reported use of recreational drugs, p = .001; living alone, p = .041; feeling depressed, p = .02; being influenced by the media, p = .037; and lack of a close confidant, p = .037. Greater adherence was associated with clients reporting a positive mental attitude to HIV infection, p = .038. Principal component analysis (PCA) of each self-report tool identified two well-recognized constructs: intentional nonadherence and nonintentional nonadherence. In addition, a third construct of following instructions was identified from PAM, a scale developed by the authors. Subsequent regression analysis failed to confirm the associations with adherence suggested by the univariate analysis. Conclusion: This study suggests that the design and use of self-report tools to identify client’s adherence to complex antiretroviral regimens may need to measure individual constructs of adherence to accurately assess adherence behavior.