Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence
Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence
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DOI：
10.1007/bf02879920
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发表时间：
2007-01-01
影响因子：
3.8
通讯作者：
Horne, Rob
中科院分区：
文献类型：
--
作者：
Gonzalez, Jeffrey S.;Penedo, Frank J.;Horne, Rob
背景资料：接近完美的艾滋病毒药物治疗依从性水平是治疗成功所必需的，然而，许多患者继续报告不依从艾滋病毒治疗。目的：本研究探讨了HIV症状和药物依从性之间的关系，并评估了对HIV药物和负面情绪状态的信念作为这种关系的潜在中介。方法：采用15个月纵向设计，用结构方程模型检验这些关系。种族多样的便利样本包括325名与男性发生性关系的艾滋病毒感染男性和接受高效抗逆转录病毒治疗（HAART）的女性。结果如下：结果表明，更多的症状与较差的药物依从性相关，这种关系部分是由对HAART的担忧增加介导的。在最终的模型中，对HAART的担忧和对药物的普遍不信任都预测了HAART依从性较差。HAART的必要性信念和教育程度预测更好的坚持。最终模型解释了HAART依从性的约24%的方差。结论：这项研究的结果表明，霍恩（1）的必要性关注框架可以成功地应用于确定药物的信念，随着时间的推移，坚持HAART的重要预测因素。这些发现对于制定干预措施以改善艾滋病毒感染者的药物依从性具有相关性。
Background: Near-perfect levels of HIVmedication adherence are necessary for treatment to be successful However, many patients continue to report nonadherence to HIV treatment. Purpose: This study examines the relationship between symptoms of HIV and medication adherence and evaluates belie about HIV medications and negative mood states as potential mediators of this relationship. Methods: These relationships were tested with structural equation modeling using a 15-month longitudinal design. The ethnically diverse convenience sample included 325 HIV-infected men who have sex with men and women prescribed Highly Active Antiretroviral Therapy (HAART). Results: Results showed that a greater number of symptoms were associated with poorer medication adherence, and this relationship was partially mediated by increases in concerns about HAART Contrary to expectations, negative mood states were not directly related to medication adherence. In the final model, concerns about HAART and general distrust of medications each predicted poorer HAART adherence. Necessity beliefs about HAART and level of educational attainment each predicted better adherence. The final model accounted for approximately 24% of the variance in HAART adherence. Conclusions: The results of this study suggest that Horne's (1) necessity-concerns framework can be successfully applied to identify beliefs about medication that are important predictors of adherence to HAART over time. These findings have relevance for developing interventions to improve medication adherence among HIV-infected patients.