Psychosocial Determinants of Adherence to Highly Active Antiretroviral Therapy among Injection Drug Users in Vancouver
Psychosocial Determinants of Adherence to Highly Active Antiretroviral Therapy among Injection Drug Users in Vancouver
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温哥华注射吸毒者坚持高效抗逆转录病毒治疗的社会心理决定因素
DOI：
10.1177/135965350400900314
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发表时间：
2003
影响因子：
1.2
通讯作者：
E. Wood
中科院分区：
文献类型：
--
作者：
T. Kerr;A. Palepu;G. Barnes;J. Walsh;R. Hogg;J. Montaner;M. Tyndall;E. Wood
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.
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2001-07-01
期刊：
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