BASELINE PREDICTORS OF THREE TYPES OF ANTIRETROVIRAL THERAPY (ART) ADHERENCE: A 2-YEAR FOLLOW-UP Nilsson Schönnesson L. 1 Diamond P. 2 Ross MW. 2 Williams M. 2 Bratt G. 1 1 Gay Men’s Health Clinic, Infectious Disease Clinic, Karolinska University Hospital, Department Karolinska Institute/South Hospital, Stockholm, Sweden 2 Center for Health Promotion and Prevention Research, School of Public HealthUniversity of Texas Health Science Center at Houston, Houston, Texas, U.S.A.
Purposes: 1.to measure patient ART adherence to dose, schedule, and dietary instructions over a two-year period; 2.to identify predictors of the three types of adherence
Potential predictors of three types of adherence (dose, schedule, and dietary instructions) Intra-personal factors Inter-personal factors Extra-personal factors Psychological factors 1. Psychological distress Depressive symptoms; Anxiety symptoms; HopelessnessSupport Patient-doctor relationship; Satisfaction with social support; External medication demands SociodemographicsGender;Age; Sexual preference; Partner status; Education;Work; Years since HIV diagnosis 2. Stressors HIV-stress; Life stress Biomedical factors CD4;HIV-RNA; AIDS diagnosis 3. Coping Resiliency;Avoidance Medication regimen NRTI + PI; NNRTI+NRTI;NNRTI+NRTI+PI;NRTI Number of pills; Number of drugs; Time being on ART; Medication adverse side effects Cognitive factors HIV severity; ART health concerns; ART benefits; Adherence self-efficacy
Table 1 Baseline demographic and medication regimen characteristics of patients (n = 144) Characteristics% Gender Female Female Male Male2278 Age > Sexual preference Homosexual Homosexual Bisexual Bisexual Heterosexual Heterosexual Education High school High school Some college Some college University degree University degree Steady job Yes Yes No No6337 Partner status Partner Partner Single Single5941
Year of HIV diagnosis Protease inhibitor-based regimen Yes Yes No No6040 Time on ART 1 year 1 year 2 years 2 years 3 years 3 years 4 years 4 years 5 years 5 years Total number of HIV drugs > 4> Table 1/cont.
Table 2 Proportion of patients classified as 100% adherent at baseline and at each of the seven follow up visits BaselineT1T2T3T4T5T6T7 Dose Schedule Dietary instructions
DoseSchedule 100% adherent all visits Non adherent at least at one visit Never 100% adherent 1616 Table 3 Proportion of patients classified as
BS.E.Sig.OR ART health concerns Adherence self-efficacy HIV stress Life stress HIV disease severity Social networtk medication demands Health care medication demands Table 4 Logistic regression analysis on predictors of schedule adherence
ACKNOWLEDGMENT Our gratitude goes to: those women and men who participated in the study; the nurses at Gay Men’s Health Clinic, Söder Hospital and HIV Clinic, Karolinska Hospital for administrating the questionnaires; the Swedish Foundation for Health Care Sciences and Allergy Research; Department of Research, Education, and Development, Stockholm City Council; the Magn Bergvall’s Foundation; the Swedish Physicians against AIDS Research Foundation, and the National Institute on Drug Abuse, USA, R03 DA