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Conference
"Psychosocial Determinants of Adherence in HIV" Dr. Josie Geller (biography) English - 2003-03-29 - 46 minutes
Summary : Antiretroviral therapy represents a complex and demanding set of challenges for individuals living with HIV. Despite newer formulations of antiretrovirals that require fewer pills and dosing times, compliance can still be very demanding in light of psychological, economic, and medical challenges faced by individuals living with HIV. Understanding the factors that contribute to achieving and maintaining adherence to antiretroviral treatment is critical.
Research and clinical experience suggests that adherence is affected by a complex array of psychological and health related challenges. These include patient's experiences of social and medical support, beliefs regarding their own ability to overcome barriers to adherence, beliefs about medication outcomes, drug and alcohol use, and motivation stage of change.
Several clinical research projects are contributing to our understanding of these factors. The first involves the development and validation of a measure of readiness for adherence to antiretrovirals, the Antiretroviral Readiness and Motivate Scale. This tool will enable treatment providers to target persons who are not ready for treatment with appropriate preparatory interventions to increase readiness. This could result in improved quality of care to persons living with HIV, reduced risk to the general public, and savings to the health care system.
Two other qualitative projects are also underway to better understand barriers to adherence, as described by HIV patients. The first identifies themes that characterize patient's decision to decline antiretroviral therapy. The second examines the experiences of individuals described by their physicians as "treatment successes". In this latter project, factors that assist and hinder adherence in individuals who have been successful at sticking to their antiretroviral therapy regimes are identified.
This work highlights factors that assist and hinder care provider-patient interactions in preparing patients for antiretroviral therapy. Encouraging open and honest discussion of barriers to adherence is useful early on in treatment and may assist individuals in identifying needs and accessing appropriate resources. Ways of incorporating knowledge of these factors into treatment, and of promoting productive discussions about adherence will be addressed.
Bibliographic references : http://www.sciencedirect.com/science
J Psychosom Res 2003 Mar;54(3):271-8
Personality, quality of life and HAART adherence among men and women living with HIV/AIDS.
Penedo FJ, Gonzalez JS, Dahn JR, Antoni M, Malow R, Costa P, Schneiderman N.
Antivir Ther 2002 Sep;7(3):185-93
Consequences and determinants of adherence to antiretroviral medication: results from Adult AIDS Clinical Trials Group protocol 370.
Ickovics JR, Cameron A, Zackin R, Bassett R, Chesney M, Johnson VA, Kuritzkes DR; Adult AIDS Clinical Trials Group 370 Protocol Team
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