Investigating the potentially important role of psychological flexibility in adherence to antiretroviral therapy in people living with HIV
Open accessAbstract
Antiretroviral therapy (ART) has significantly improved immune health and survival rates in HIV, but these outcomes rely on near perfect adherence. While many psychosocial factors are related to sub-optimal adherence, effectiveness of associated interventions are modest or inconsistent. The Psychological Flexibility (PF) model underlying Acceptance and Commitment Therapy (ACT) identifies a core set of broadly applicable transdiagnostic processes that may be useful to explain and improve non-adherence. However, PF has not previously been examined in relation to ART adherence. Therefore, this cross-sectional study (n = 275) explored relationships between PF and intentional/unintentional ART non-adherence in people with HIV. Adults with HIV prescribed ART were recruited online. Participants completed online questionnaires assessing self-reported PF, adherence and emotional and general functioning. Logistic regressions examined whether PF processes were associated with intentional/unintentional non-adherence. Fifty-eight percent of participants were classified as nonadherent according to the Medication Adherence Rating Scale, of which 41.0% reported intentional and 94.0% unintentional non-adherence. Correlations between PF and adherence were small. PF did not significantly explain intentional/unintentional non-adherence after controlling for demographic and disease factors. Further clarification of the utility of PF in understanding ART non-adherence is warranted using prospective or experimental designs in conjunction with more objective adherence measures.
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Psychological flexibility is a broad treatment target comprising a range of emotional and motivational factors that may contribute to non-adherence.
“First, psychological flexibility is a broad treatment target comprising a range of emotional and motivational factors that may contribute to non-adherence.”
ACT may be a suitable approach in this setting.
“ACT may be a suitable approach in this setting for two main reasons [13, 27–30].”
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Self-citation
- Authors
- Harrison, A., Scott, W., Timmins, L., Graham, C. D., & Harrison, A. M.
- Affiliations
- National Health Service (GB)
- King's College London (GB)
- Queen's University Belfast (GB)
- Corresponding author
- Harrison, Anthony M.
- Venue
- AIDS Care
- Publisher
- Informa UK Limited
- Published
- 2020-05-29
- Volume
- 33
- Issue
- 3
- Pages
- 337-346
- ISSN
- 0954-0121 (ISSN-L)
- 1360-0451
- OpenAlex
- W3026699769
- Cited by
- 12
- References
- 77
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2022: 6 · 2021: 1
- FWCI
- 0.29
- Type
- journal article
- Language
- en
- Open access
- Locations
- AIDS Care (publishedVersion)
- PubMed (publishedVersion)
- CLOK (University of Central Lancashire) (acceptedVersion)
- Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (submittedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- psychological flexibility, antiretroviral therapy adherence, HIV, medication non-adherence, intentional non-adherence, unintentional non-adherence, acceptance and commitment therapy, psychosocial factors, emotional functioning, general functioning
- MeSH terms
- Adult, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, HIV Infections, Drug Monitoring, Intention, Medication Adherence, Acceptance and Commitment Therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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