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Psychosocial determinants of adherence to highly active antiretroviral therapy among injection drug users in Vancouver.
Antivir Ther. 2004 Jun; 9(3):407-14.AT

Abstract

BACKGROUND

Sub-optimal adherence to highly active antiretroviral therapy (HAART) among injection drug users (IDUs) is a significant concern. As such, there is an urgent need to identify psychosocial determinants of adherence that can be incorporated into interventions designed to promote optimal adherence.

OBJECTIVE

To identify psychosocial determinants of adherence to HAART, as well as self-reported reasons for missing doses of HAART among HIV-infected IDUs.

METHODS

We developed an eight-item adherence self-efficacy scale comprised of two sub-scales: adherence efficacy and self-regulatory efficacy. We examined correlates between adherence self-efficacy, outcome expectations, socio-demographic characteristics, drug use and risk behaviours, social support and HAART adherence among 108 HIV-infected participants in the Vancouver Injection Drug Users Study (VIDUS). Pharmacy-based adherence to HAART was obtained through a confidential record linkage to the province of British Columbia's HIV/AIDS Drug Treatment Program. Participants were defined as adherent if they picked-up 95% of their HAART prescriptions. Participants were also asked to indicate reasons for missing doses of HAART. Logistic regression was used to identify the factors independently associated with adherence to HAART.

RESULTS

Seventy-one (66%) HIV-infected IDUs were less than 95% adherent. Forgetting was the most frequently cited reason (27%) for missing doses of HAART. Factors independently associated with adherence to HAART included adherence efficacy expectations [OR=1.8 (95% CI: 1.0-3.1); P=0.039] and negative outcome expectations [OR=0.8 (95% CI: 0.7-0.9); P=0.027].

CONCLUSIONS

We found low rates of adherence to HAART among IDUs. Psychological constructs derived from self-efficacy theory are highly germane to the understanding of adherence behaviour, and interventions that address these constructs should be developed and tested among HIV-infected drug users.

Authors+Show Affiliations

Canadian HIV/AIDS Legal Network, Montreal, Que., Canada. tkerr@aidslaw.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15259903

Citation

Kerr, Thomas, et al. "Psychosocial Determinants of Adherence to Highly Active Antiretroviral Therapy Among Injection Drug Users in Vancouver." Antiviral Therapy, vol. 9, no. 3, 2004, pp. 407-14.
Kerr T, Palepu A, Barness G, et al. Psychosocial determinants of adherence to highly active antiretroviral therapy among injection drug users in Vancouver. Antivir Ther. 2004;9(3):407-14.
Kerr, T., Palepu, A., Barness, G., Walsh, J., Hogg, R., Montaner, J., Tyndall, M., & Wood, E. (2004). Psychosocial determinants of adherence to highly active antiretroviral therapy among injection drug users in Vancouver. Antiviral Therapy, 9(3), 407-14.
Kerr T, et al. Psychosocial Determinants of Adherence to Highly Active Antiretroviral Therapy Among Injection Drug Users in Vancouver. Antivir Ther. 2004;9(3):407-14. PubMed PMID: 15259903.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychosocial determinants of adherence to highly active antiretroviral therapy among injection drug users in Vancouver. AU - Kerr,Thomas, AU - Palepu,Anita, AU - Barness,Gordon, AU - Walsh,John, AU - Hogg,Robert, AU - Montaner,Julio, AU - Tyndall,Mark, AU - Wood,Evan, PY - 2004/7/21/pubmed PY - 2005/1/7/medline PY - 2004/7/21/entrez SP - 407 EP - 14 JF - Antiviral therapy JO - Antivir Ther VL - 9 IS - 3 N2 - BACKGROUND: Sub-optimal adherence to highly active antiretroviral therapy (HAART) among injection drug users (IDUs) is a significant concern. As such, there is an urgent need to identify psychosocial determinants of adherence that can be incorporated into interventions designed to promote optimal adherence. OBJECTIVE: To identify psychosocial determinants of adherence to HAART, as well as self-reported reasons for missing doses of HAART among HIV-infected IDUs. METHODS: We developed an eight-item adherence self-efficacy scale comprised of two sub-scales: adherence efficacy and self-regulatory efficacy. We examined correlates between adherence self-efficacy, outcome expectations, socio-demographic characteristics, drug use and risk behaviours, social support and HAART adherence among 108 HIV-infected participants in the Vancouver Injection Drug Users Study (VIDUS). Pharmacy-based adherence to HAART was obtained through a confidential record linkage to the province of British Columbia's HIV/AIDS Drug Treatment Program. Participants were defined as adherent if they picked-up 95% of their HAART prescriptions. Participants were also asked to indicate reasons for missing doses of HAART. Logistic regression was used to identify the factors independently associated with adherence to HAART. RESULTS: Seventy-one (66%) HIV-infected IDUs were less than 95% adherent. Forgetting was the most frequently cited reason (27%) for missing doses of HAART. Factors independently associated with adherence to HAART included adherence efficacy expectations [OR=1.8 (95% CI: 1.0-3.1); P=0.039] and negative outcome expectations [OR=0.8 (95% CI: 0.7-0.9); P=0.027]. CONCLUSIONS: We found low rates of adherence to HAART among IDUs. Psychological constructs derived from self-efficacy theory are highly germane to the understanding of adherence behaviour, and interventions that address these constructs should be developed and tested among HIV-infected drug users. SN - 1359-6535 UR - https://www.unboundmedicine.com/medline/citation/15259903/Psychosocial_determinants_of_adherence_to_highly_active_antiretroviral_therapy_among_injection_drug_users_in_Vancouver_ L2 - http://hivinsite.ucsf.edu/InSite?page=kb-03-02-09 DB - PRIME DP - Unbound Medicine ER -