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Cited by 133HIV/AIDS Research and InterventionsMedication Adherence and ComplianceHIV, Drug Use, Sexual Risk

Individual and System Level Factors Associated with Treatment Nonadherence in Human Immunodeficiency Virus-infected Men and Women

van Servellen, Gwen, Chang, Betty, Garcia, Lorraine, Lombardi, Emilia·2002·AIDS Patient Care and STDs
DOI 10.1089/10872910260066705
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Abstract

Antiretroviral treatment nonadherence is complex, implicating more than a patient's ability and motivation to be compliant. The bulk of the research to date focuses on individual level barriers with less emphasis on the many system level factors that potentially impact patients' adherence behaviors. This study examined the effects of system enabling factors in addition to the frequently studied individual predisposing and enabling factors upon nonadherence to treatment. One hundred eighty-two patients from five community-based clinics were interviewed and their medical charts examined. Patients' self-reported nonadherence was correlated with clinicians' assessments of medication and appointment nonadherence. Seven individual predisposing factors (gender, ethnicity, birthplace, years of education, HIV Overview of Problems-Evaluation System [HOPES] psychosocial, Hospital Anxiety and Depression Scale [HADS] anxiety, and HADS depression scores) were found to be significantly associated with treatment adherence/nonadherence. Individual enabling factors (hopefulness and access to health care), as well as treatment by clinic staff, a system enabling factor, were significantly associated with adherence/nonadherence. In a multivariate analysis, six factors - age (younger), gender (female), birth outside the United States, level of hopefulness (lower), access to health care (lower), and treatment by clinic staff (poorer) - accounted for 19.3% of the variance in nonadherence. Results of this study indicated that several individual predisposing and enabling factors were potential predictors of treatment nonadherence; however, system enabling factors, e.g., treatment by clinic staff were also associated with treatment nonadherence. Further studies are needed to examine the complex relationships of individual and system related factors in predicting treatment nonadherence.

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  • Higher levels of hope are associated with improved treatment adherence, ability to cope with illness and loss, and enhanced psychological adjustment.

    “It is clinically important as higher levels of hope are associated with improved treatment adherence, ability to cope with illness and loss and also enhanced psychological adjustment (Snyder, 2002;Van Servellen, Chang, Garcia, & Lombardi, 2002;Weis & Speridakos, 2011).”

    From Brief group‐based acceptance and commitment therapy for stroke survivors. (2019) · cites this paper as Van Servellen et al., 2002

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Authors
van Servellen, G., Chang, B., Garcia, L., & Lombardi, E.
Affiliations
  • School of Nursing, University of California, Los Angeles, Los Angeles, California
  • University of California, Los Angeles (US)
ORCID
Lombardi, Emilia
Venue
AIDS Patient Care and STDs
Publisher
SAGE Publications
Published
2002-06
Volume
16
Issue
6
Pages
269-281
ISSN
  • 1087-2914 (ISSN-L)
  • 1557-7449
DOI
10.1089/10872910260066705
OpenAlex
W2063008432
Cited by
133
References
36
Citations by year
2026: 1 · 2024: 2 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 7 · 2016: 10 · 2015: 4 · 2014: 8 · 2013: 7 · 2012: 11
FWCI
4.35
Type
journal article
Language
en
Open access
closed
Locations
  • AIDS Patient Care and STDs (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
antiretroviral therapy, medication adherence, HIV infection, hope, health care access, gender differences, anxiety, depression, psychosocial factors, community clinics
MeSH terms
Adult, Attitude to Health, Cross-Sectional Studies, Data Collection, Female, Humans, Male, Los Angeles, HIV Infections, Treatment Refusal, Age Distribution, Sex Distribution, Anti-HIV Agents

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