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Changes in Stress, Substance Use and Medication Beliefs are Associated with Changes in Adherence to HIV Antiretroviral Therapy

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Abstract

Stress, substance use and medication beliefs are among the most frequently cited barriers to HIV treatment adherence. This study used longitudinal techniques to examine the temporal relationship between these barriers and adherence among clients attending treatment adherence support programs in New York State. A total of 4,155 interview pairs were analyzed across three interview transitions. Multinomial models were constructed with four-category change-based independent variables (e.g., low stress at both interviews, low stress at interview 1 and high stress at interview 2, high stress at interview 1 and low stress at interview 2, high stress at both interviews) that predicted a similarly constructed four-category adherence change variable. Clients who reported positive changes in stress, substance use, or medication beliefs were more likely to change from being nonadherent to being adherent, while clients who reported negative changes were more likely to change from being adherent to being nonadherent. To improve or maintain adherence over time, strategies should be used that facilitate positive changes—and prevent negative changes—in stress, substance use, and medication beliefs.

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References

  1. Hogg RS, Anis A, Weber AE, O’Shaughnessy MV, Schecter MT. Triple-combination antiretroviral therapy in sub-Saharan Africa. Lancet. 1997;350(9088):1406.

    Article  PubMed  CAS  Google Scholar 

  2. Palella FJ, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection HIV Outpatient Study Investigators. N Engl J Med. 1998;338(13):853–60.

    Article  PubMed  Google Scholar 

  3. Gallant JE. Strategies for long-term success in the treatment of HIV infection. JAMA. 2000;283(10):1329–34.

    Article  PubMed  CAS  Google Scholar 

  4. Machtinger EL, Bangsberg DR. Seven steps to better adherence: a practical approach to promoting adherence to antiretroviral therapy. AIDS Read. 2007;17(1):43–51.

    PubMed  Google Scholar 

  5. Haubrich RH, Little SJ, Currier JS, et al. The value of patient-reported adherence to antiretroviral therapy in predicting virologic and immunologic response. California Collaborative Treatment Group. AIDS. 1999;13(9):1099–107.

    Article  PubMed  CAS  Google Scholar 

  6. Maher K, Klimas N, Fletcher MA, et al. Disease progression, adherence, and response to protease inhibitor therapy for HIV infection in an Urban Veterans Affairs Medical Center. J Acquir Immune Defic Syndr. 1999;22(4):358–63.

    Article  PubMed  CAS  Google Scholar 

  7. Paterson DL, Swindells S, Mohr J, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133(1):21–30.

    PubMed  CAS  Google Scholar 

  8. Knobel H, Guelar A, Carmona A, et al. Virologic outcome and predictors of virologic failure of highly active antiretroviral therapy containing protease inhibitors. AIDS Patient Care STDS. 2001;15(4):193–9.

    Article  PubMed  CAS  Google Scholar 

  9. Dybul M, Fauci AS, Bartlett JG, Kaplan JE, Pau AK. Guidelines for using antiretroviral agents among HIV-infected adults and adolescents. Ann Intern Med. 2002;137(5 Pt 2):381–433.

    PubMed  Google Scholar 

  10. Press N, Tyndall MW, Wood E, Hogg RS, Montaner JS. Virologic and immunologic response, clinical progression, and highly active antiretroviral therapy adherence. J Acquir Immune Defic Syndr. 2002;31(Suppl 3):S112–7.

    PubMed  Google Scholar 

  11. Pomerantz RJ. Primary HIV-1 resistance: a new phase in the epidemic? JAMA. 1999;282(12):1177–9.

    Article  PubMed  CAS  Google Scholar 

  12. Bangsberg DR, Hecht FM, Charlebois ED, et al. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. AIDS. 2000;14(4):357–66.

    Article  PubMed  CAS  Google Scholar 

  13. Sethi AK, Celentano DD, Gange SJ, Moore RD, Gallant JE. Association between adherence to antiretroviral therapy and human immunodeficiency virus drug resistance. Clin Infect Dis. 2003;37(8):1112–8.

    Article  PubMed  Google Scholar 

  14. Bangsberg DR, Perry S, Charlebois ED, et al. Non-adherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS. 2001;15(9):1181–3.

    Article  PubMed  CAS  Google Scholar 

  15. Hogg RS, Heath KV, Yip B, et al. Improved survival among HIV-infected individuals following initiation of antiretroviral therapy. JAMA. 1998;279(6):450–4.

    Article  PubMed  CAS  Google Scholar 

  16. Hogg RS, Heath K, Bangsberg D, et al. Intermittent use of triple-combination therapy is predictive of mortality at baseline and after 1 year of follow-up. AIDS. 2002;16(7):1051–8.

    Article  PubMed  Google Scholar 

  17. Ammassari A, Trotta MP, Murri R, et al. Correlates and predictors of adherence to highly active antiretroviral therapy: overview of published literature. J Acquir Immune Defic Syndr. 2002;31(Suppl 3):S123–7.

    PubMed  Google Scholar 

  18. French T, Weiss L, Waters M, Tesoriero J, Finkelstein R, Agins B. Correlation of a brief perceived stress measure with nonadherence to antiretroviral therapy over time. J Acquir Immune Defic Syndr. 2005;38(5):590–7.

    Article  PubMed  Google Scholar 

  19. Waldrop-Valverde D, Valverde E. Homelessness and psychological distress as contributors to antiretroviral nonadherence in HIV-positive injecting drug users. AIDS Patient Care STDS. 2005;19(5):326–34.

    Article  PubMed  Google Scholar 

  20. Mugavero M, Ostermann J, Whetten K, et al. Barriers to antiretroviral adherence: the importance of depression, abuse, and other traumatic events. AIDS Patient Care STDS. 2006;20(6):418–28.

    Article  PubMed  Google Scholar 

  21. Leserman J, Ironson G, O’Cleirigh C, Fordiani JM, Balbin E. Stressful life events and adherence in HIV. AIDS Patient Care STDS. 2008;22(5):403–11.

    Article  PubMed  Google Scholar 

  22. Arnsten JH, Demas PA, Grant RW, et al. Impact of active drug use on antiretroviral therapy adherence and viral suppression in HIV-infected drug users. J Gen Intern Med. 2002;17(5):377–81.

    PubMed  Google Scholar 

  23. Power R, Koopman C, Volk J, et al. Social support, substance use, and denial in relationship to antiretroviral treatment adherence among HIV-infected persons. AIDS Patient Care STDS. 2003;17(5):245–52.

    Article  PubMed  Google Scholar 

  24. Gebo KA, Keruly J, Moore RD. Association of social stress, illicit drug use, and health beliefs with nonadherence to antiretroviral therapy. J Gen Intern Med. 2003;18(2):104–11.

    Article  PubMed  Google Scholar 

  25. Hinkin CH, Barclay TR, Castellon SA, et al. Drug use and medication adherence among HIV-1 infected individuals. AIDS Behav. 2007;11(2):185–94.

    Article  PubMed  Google Scholar 

  26. Weidle PJ, Ganera CE, Irwin KL, et al. Adherence to antiretroviral medications in an inner-city population. J Acquir Immune Defic Syndr. 1999;22(5):498–502.

    Article  PubMed  CAS  Google Scholar 

  27. Remien RH, Hirky AE, Johnson MO, Weinhardt LS, Whittier D, Le GM. Adherence to medication treatment: a qualitative study of facilitators and barriers among a diverse sample of HIV+ men and women in four US cities. AIDS Behav. 2003;7(1):61–72.

    Article  PubMed  Google Scholar 

  28. Reynolds NR. The problem of antiretroviral adherence: a self-regulatory model for intervention. AIDS Care. 2003;15(1):117–24.

    Article  PubMed  CAS  Google Scholar 

  29. Godin G, Cote J, Naccache H, Lambert LD, Trottier S. Prediction of adherence to antiretroviral therapy: a one-year longitudinal study. AIDS Care. 2005;17(4):493–504.

    Article  PubMed  CAS  Google Scholar 

  30. Lewis MP, Colbert A, Erlen J, Meyers M. A qualitative study of persons who are 100% adherent to antiretroviral therapy. AIDS Care. 2006;18(2):140–8.

    Article  PubMed  CAS  Google Scholar 

  31. Barclay TR, Hinkin CH, Castellon SA, et al. Age-associated predictors of medication adherence in HIV-positive adults: health beliefs, self-efficacy, and neurocognitive status. Health Psychol. 2007;26(1):40–9.

    Article  PubMed  Google Scholar 

  32. Carrieri P, Cailleton V, Le Moing V, et al. The dynamic of adherence to highly active antiretroviral therapy: results from the French National APROCO cohort. J Acquir Immune Defic Syndr. 2001;28(3):232–9.

    PubMed  CAS  Google Scholar 

  33. Duran S, Savès M, Spire B, et al. Failure to maintain long-term adherence to highly active antiretroviral therapy: the role of lipodystrophy. AIDS. 2001;15(18):2441–4.

    Article  PubMed  CAS  Google Scholar 

  34. Hill Z, Kendall C, Fernandez M. Patterns of adherence to antiretrovirals: why adherence has no simple measure. AIDS Patient Care STDS. 2003;17(10):519–25.

    Article  PubMed  Google Scholar 

  35. Lucas GM, Cheever LW, Chaisson RE, Moore RD. Detrimental effects of continued illicit drug use on the treatment of HIV-1 infection. J Acquir Immune Defic Syndr. 2001;27(3):251–9.

    Article  PubMed  CAS  Google Scholar 

  36. Tesoriero J, French T, Weiss L, Waters M, Finkelstein R, Agins B. Stability of adherence to highly active antiretroviral therapy over time among clients enrolled in the treatment adherence demonstration project. J Acquir Immune Defic Syndr. 2003;33(4):484–93.

    Article  PubMed  Google Scholar 

  37. Kleeberger CA, Buechner J, Palella F, et al. Changes in adherence to highly active antiretroviral therapy medications in the Multicenter AIDS Cohort Study. AIDS. 2004;18(4):683–8.

    Article  PubMed  Google Scholar 

  38. Gonzalez JS, Penedo FJ, Llabre MM, et al. Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence. Ann Behav Med. 2007;34(1):46–55.

    Article  PubMed  Google Scholar 

  39. Lazo M, Gange SJ, Wilson TE, et al. Patterns and predictors of changes in adherence to highly active antiretroviral therapy: longitudinal study of men and women. Clin Infect Dis. 2007;45(10):1377–85.

    Article  PubMed  Google Scholar 

  40. Halkitis P, Palamar J, Mukherjee P. Analysis of HIV medication adherence in relation to person and treatment characteristics using hierarchical linear modeling. AIDS Patient Care STDS. 2008;22(4):323–35.

    Article  PubMed  Google Scholar 

  41. Glass TR, Battegay M, Cavassini M, et al. Longitudinal analysis of patterns and predictors of changes in self-reported adherence to antiretroviral therapy: Swiss HIV Cohort Study. J Acquir Immune Defic Syndr. 2010;54(2):197–203. doi:10.1097/QAI.0b013e3181ca48bf.

    PubMed  Google Scholar 

  42. Kacanek D, Jacobson DL, Spiegelman D, Wanke C, Isaac R, Wilson IB. Incident depression symptoms are associated with poorer HAART adherence: a longitudinal analysis from the Nutrition for Healthy Living Study. J Acquir Immune Defic Syndr. 2010;53(2):266–72.

    Article  PubMed  Google Scholar 

  43. Lucas GM, Gebo KA, Chaisson RE, Moore RD. Longitudinal assessment of the effects of drug and alcohol abuse on HIV-1 treatment outcomes in an urban clinic. AIDS. 2002;16(5):767–74.

    Article  PubMed  Google Scholar 

  44. Weiss LJ, French PT, Waters MD, Agins B, Finkelstein R. Adherence support: the importance of linkages to clinical care. Presented at: XIV International AIDS Conference; Barcelona; 2002.

  45. Chesney MA, Ickovics JR, Chambers DB, et al. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group (AACTG). AIDS Care. 2000;12(3):255–66.

    Article  PubMed  CAS  Google Scholar 

  46. Bangsberg DR. Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis. 2006;43(7):939–41.

    Article  PubMed  CAS  Google Scholar 

  47. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96.

    Article  PubMed  CAS  Google Scholar 

  48. Klinkenberg WD, Sacks S. Mental disorders and drug abuse in persons living with HIV/AIDS. AIDS Care. 2004;16(Suppl 1):22–42.

    Article  Google Scholar 

  49. Angelino AF, Treisman GJ. Management of psychiatric disorders in patients infected with human immunodeficiency virus. Clin Infect Dis. 2001;33(6):847–56.

    Article  PubMed  CAS  Google Scholar 

  50. Bing EG, Burnam MA, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58(8):721–8.

    Article  PubMed  CAS  Google Scholar 

  51. Tegger MK, Crane HM, Tapia KA, Uldall KK, Holte SE, Kitahata MM. The effect of mental illness, substance use, and treatment for depression on the initiation of highly active antiretroviral therapy among HIV-infected individuals. AIDS Patient Care STDS. 2008;22(3):233–43.

    Article  PubMed  Google Scholar 

  52. Berger-Greenstein JA, Cuevas CA, Brady SM, Trezza G, Richardson MA, Keane TM. Major depression in patients with HIV/AIDS and substance abuse. AIDS Patient Care STDS. 2007;21(12):942–55.

    Article  PubMed  Google Scholar 

  53. Liu H, Golin CE, Miller LG, et al. A comparison study of multiple measures of adherence to HIV protease inhibitors. Ann Intern Med. 2001;134(10):1004–6.

    Google Scholar 

  54. Simoni JM, Kurth AE, Pearson CR, Pantalone DW, Merrill JO, Frick PA. Self-report measures of antiretroviral therapy adherence: a review with recommendations for HIV research and clinical management. AIDS Behav. 2006;10(3):247–8.

    Article  Google Scholar 

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Acknowledgements

The authors gratefully acknowledge the assistance of the staff and clients of the treatment adherence support programs at: AIDS Community Resources, Albany Medical Center, Albert Einstein College of Medicine, Bellevue Hospital Center, Beth Israel Medical Center, Brooklyn AIDS Task Force, Community Health Network, Erie County Medical Center, Harlem Hospital Center, Kings County Medical Center, Joseph L. Mailman School of Public Health of Columbia University, Long Island Jewish Medical Center, Montefiore Medical Center, Mount Sinai Medical Center, Nassau University Medical Center, North Shore University Hospital, New York Presbyterian Hospital, SUNY Health Science Center of Brooklyn, Village Center for Care, and Westchester Medical Center.

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French, T., Tesoriero, J. & Agins, B. Changes in Stress, Substance Use and Medication Beliefs are Associated with Changes in Adherence to HIV Antiretroviral Therapy. AIDS Behav 15, 1416–1428 (2011). https://doi.org/10.1007/s10461-010-9762-4

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