Antiretroviral therapy adherence among patients living with HIV/AIDS in Thailand
Corresponding Author
Li Li phd
Center for Community Health, Semel Institute, University of California, Los Angeles, California, USA and
Li Li, UCLA Semel Institute – Center for Community Health, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024, USA. Email: [email protected]Search for more papers by this authorSung-Jae Lee phd
Center for Community Health, Semel Institute, University of California, Los Angeles, California, USA and
Search for more papers by this authorYi Wen md
Center for Community Health, Semel Institute, University of California, Los Angeles, California, USA and
Search for more papers by this authorChunqing Lin phd
Center for Community Health, Semel Institute, University of California, Los Angeles, California, USA and
Search for more papers by this authorDai Wan msc
Center for Community Health, Semel Institute, University of California, Los Angeles, California, USA and
Search for more papers by this authorChuleeporn Jiraphongsa phd
Bureau of Epidemiology, Ministry of Public Health, Bangkok, Thailand
Search for more papers by this authorCorresponding Author
Li Li phd
Center for Community Health, Semel Institute, University of California, Los Angeles, California, USA and
Li Li, UCLA Semel Institute – Center for Community Health, 10920 Wilshire Blvd, Suite 350, Los Angeles, CA 90024, USA. Email: [email protected]Search for more papers by this authorSung-Jae Lee phd
Center for Community Health, Semel Institute, University of California, Los Angeles, California, USA and
Search for more papers by this authorYi Wen md
Center for Community Health, Semel Institute, University of California, Los Angeles, California, USA and
Search for more papers by this authorChunqing Lin phd
Center for Community Health, Semel Institute, University of California, Los Angeles, California, USA and
Search for more papers by this authorDai Wan msc
Center for Community Health, Semel Institute, University of California, Los Angeles, California, USA and
Search for more papers by this authorChuleeporn Jiraphongsa phd
Bureau of Epidemiology, Ministry of Public Health, Bangkok, Thailand
Search for more papers by this authorAbstract
The importance of antiretroviral therapy adherence for patients living with HIV/AIDS has been well documented. Despite this critical need, many do not follow prescribed regimens. To examine the barriers that lead to non-adherence, we used cross-sectional survey data from a randomized controlled intervention trial in northern and north-eastern Thailand. Of the 507 patients that were enrolled in the trial, we analyzed 386 patients on antiretroviral therapy in order to examine the barriers to adherence. In addition to demographic characteristics, depressive symptoms, physical health, access to care, social support, and internalized shame, HIV disclosure and family communication were examined. The correlation analysis revealed that adherence is significantly associated with internalized shame, access to care, depressive symptoms, and family communication. Based on the multiple logistic regression analysis, depressive symptoms, access to care, HIV disclosure, and family communication were significant predictors of adherence. Having depressive symptoms remains a significant barrier to adherence, while access to care, HIV disclosure, and family communication play important positive roles. Our findings underscore the critical importance of addressing these various challenges that can influence adherence to antiretroviral therapy.
REFERENCES
- Amberbir A, Woldemichael K, Getachew S, Girma B, Deribe K. Predictors of adherence to antiretroviral therapy among HIV-infected persons: a prospective study in southwest Ethiopia. BMC Public Health 2008; 8: 265.
- Ammassari A, Antinori A, Aloisi MS et al. Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons. Psychosomatics 2004; 45: 395–402.
- 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–S127.
- Apinundecha C, Laohasiriwong W, Cameron MP, Lim S. A community participation intervention to reduce HIV/AIDS stigma, Nakhon Ratchasima province, northeast Thailand. AIDS Care 2007; 19: 1157–1165.
- Bandura A. Self-efficacy: The Exercise of Control. New York: W. H. Freeman and Company, 1997.
- Bangsberg DR, Kroetz DL, Deeks SG. Adherence-resistance relationships to combination HIV antiretroviral therapy. Curr. HIV/AIDS Rep. 2007; 4: 65–72.
- Bangsberg DR, Perry S, Charlebois ED et al. Nonadherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS 2001; 15: 1181–1183.
- Berg CJ, Michelson SE, Safren SA. Behavioral aspects of HIV care: adherence, depression, substance use, and HIV-transmission behaviors. Infect. Dis. Clin. North Am. 2007; 21: 181–200.
- Bouhnik AD, Preau M, Vincent E et al. Depression and clinical progression in HIV-infected drug users treated with highly active antiretroviral therapy. Antivir. Ther. 2005; 10: 53–61.
- Carrieri MP, Leport C, Protopopescu C et al. Factors associated with nonadherence to highly active antiretroviral therapy: a 5-year follow-up analysis with correction for the bias induced by missing data in the treatment maintenance phase. J. Acquir. Immune Defic. Syndr. 2006; 41: 477–485.
- Catz SL, Kelly JA, Bogart LM et al. Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychol. 2000; 19: 124–133.
- Centers for Disease Control and Prevention. HIV/AIDS Prevention. Washington, DC: Department of Health and Human Services Public Health Service, 1997.
- Chanard C. The impact of stigma on the self-care behaviors of HIV-positive gay men striving for normalcy. J. Assoc. Nurses AIDS Care 2007; 18: 23–32.
- Chen WT, Starks H, Shiu CS et al. HIV-positive patients and their healthcare providers: contrasting Confucian versus Western notions of secrecy and support. ANS Adv. Nurs. Sci. 2007; 30: 329–342.
- Chesney MA. Factors affecting adherence to antiretroviral therapy. Clin. Infect. Dis. 2000; 2: S171–S176.
- Chesney MA. Adherence to HAART regimens. AIDS Patient Care STDs 2003; 17: 169–177.
- Crum NF, Riffenburgh RH, Wegner S et al. Comparisons of causes of death and mortality rates among HIV-infected persons: analysis of the pre-, early, and late HAART (highly active antiretroviral therapy) eras. J. Acquir. Immune Defic. Syndr. 2006; 41: 194–200.
- Deeks SG, Smith M, Holodniy M, Kahn JO. HIV-2 protease inhibitors. JAMA 1997; 277: 145–153.
- Department of Mental Health. Depression Screening Test . Bangkok: Ministry of Public Health. [Cited 12 Sep 2008.] Available from URL: http://www.dmh.go.th/test/depress/asheet.asp?qid=1.
- DiIorio C, McCarty F, DePadilla L et al. Adherence to antiretroviral medication regimens: a test of a psychosocial model. AIDS Behav. 2009; 13: 10–22.
- Donovan JL, Blake DR. Patient non-compliance: deviance or reasoned decision-making? Soc. Sci. Med. 1992; 34: 507–513.
- Epstein N, Baldwin L, Bishop D. The McMaster family assessment device. J. Marital Fam. Ther. 1983; 9: 171–180.
- Fogarty L, Roter D, Larson S, Burke J, Gillespie J, Levy R. Patient adherence to HIV medication regimens: a review of published and abstract reports. Patient Educ. Couns. 2002; 46: 93–108.
- Gardner EM, Sharma S, Peng G et al. Differential adherence to combination antiretroviral therapy is associated with virologic failure with resistance. AIDS 2008; 22: 75–82.
- Gonzalez JS, Penedo FJ, Antoni MH et al. Social support, positive states of mind, and HIV treatment adherence in men and women living with HIV/AIDS. Health Psychol. 2004; 23: 413–418.
- Hartzell JD, Spooner K, Howard R et al. Race and mental health diagnosis are risk factors for highly active antiretroviral therapy failure in a military cohort despite equal access to care. J. Acquir. Immune Defic. Syndr. 2007; 44: 411–416.
- Herek GM, Capitanio JP. Public reactions to AIDS in the United States: a second date of stigma. Am. J. Public Health 1993; 83: 574–577.
- Horberg MA, Silverberg MJ, Hurley LB et al. Effects of depression and selective serotonin reuptake inhibitor use on adherence to highly active antiretroviral therapy and on clinical outcomes in HIV-infected patients. J. Acquir. Immune Defic. Syndr. 2008; 47: 384–390.
- Ickovics JR, Cameron A, Zackin R et al. Consequences and determinants of adherence to antiretroviral medication: results from Adult AIDS Clinical Trials Group Protocol 370. Antivir. Ther. 2002; 7: 185–193.
- Jones J, Taylor B, Wilkin TJ, Hammer S. Advances in antiretroviral therapy. Top. HIV Med. 2007; 15: 48–82.
- Kalichman SC, Ramachandran B, Catz S. Adherence to combination antiretroviral therapies in HIV patients of low health literacy. J. Gen. Intern. Med. 1999; 14: 267–273.
- Lee S-J, Li L, Jiraphongsa C, Iamsirithaworn S, Khumtong S, Rotheram-Borus MJ. Regional variations in HIV disclosure in Thailand: implications for future interventions. Int. J. STD AIDS 2010 [Cited 15 Jan 2010.] Available from URL: http://ijsa.rsmjournals.com/cgi/reprint/ijsa.2009.009008v1.
- Li L, Lee S-J, Jiraphongsa C et al. Improving health and mental health for people living with HIV/AIDS: 12-month assessment of a behavioral intervention in Thailand. Am. J. Public Health 2010 (in press).
- Li L, Lee S-J, Thammawijaya P, Jiraphongsa C, Rotheram-Borus MJ. Stigma, social support, and depression among people living with HIV in Thailand. AIDS Care 2009; 21: 1007–1013.
- McInerney PA, Ncama BP, Wantland D et al. Quality of life and physical functioning in HIV-infected individuals receiving antiretroviral therapy in KwaZulu-Natal, South Africa. Nurs. Health Sci. 2008; 4: 266–272.
- Maneesriwongul WL, Tulathong S, Fennie KP, Williams AB. Adherence to antiretroviral medication among HIV-positive patients in Thailand. JAIDS 2006; 43 (Suppl. 1): S119–S122.
- Mills EJ, Nachega JB, Bangsberg DR et al. Adherence to HAART: a systematic review of developed and developing nation patient-reported barriers and facilitators. PLoS Med. 2006; 3: e438.
- Molassiotis A, Nahas-Lopez V, Chung WY, Lam SW, Li CK, Lau TF. Factors associated with adherence to antiretroviral medication in HIV-infected patients. Int. J. STD AIDS 2002; 13: 301–310.
- Murphy DA, Johnston Roberts K, Martin D, Marelich W, Hoffman D. Barriers to antiretroviral adherence among HIV-infected adults. AIDS Patient Care STDs 2000; 14: 47–58.
- Ncama BP, McInereney PA, Behngu BR et al. Social support and medication adherence in HIV disease in KwaZulu-Natal, South Africa. Int. J. Nurs. Stud. 2008; 45: 1757–1763.
- Paterson DL, Swindells S, Mohr J et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann. Intern. Med. 2002; 133: 21–30.
- 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 U.S. cities. AIDS Behav. 2003; 7: 61–72.
- Revicki DA, Sorensen S, Wu AW. Reliability and validity of physical health and mental health summary scores from the MOS HIV Health Survey. Med. Care 1998; 36: 126–137.
- Rotheram-Borus MJ, Stein JA, Jiraphongsa C, Khumtong S, Lee SJ, Li L. Benefits of family and social relationships for Thai parents living with HIV. Prev. Sci. 2009 [Cited 15 Jan 2010.] Available from URL: http://www.springerlink.com/content/l072411h2860r61x/.
- Sharma M, Singh RR, Laishram P et al. Access, adherence, quality and impact of ARV provision to current and ex-injecting drug users in Manipur (India): an initial assessment. Int. J. Drug Policy 2007; 18: 319–325.
- Sherbourne CD, Stewart AL. The MOS Social Support Survey. Soc. Sci. Med. 1991; 32: 705–714.
- Simoni JM, Amico R, Pearson CR, Malow R. Strategies for promoting adherence to antiretroviral therapy: a review of the literature. Curr. Infect. Dis. Rep. 2008; 10: 515–521.
- Simoni JM, Kurth AE, Pearson CR et al. Self-report measures of antiretroviral therapy adherence: a review with recommendations for HIV research and clinical management. AIDS Behav. 2007; 11: 161–173.
- Singh N, Berman SM, Swindells S et al. Adherence of human immunodeficiency virus-infected patients to antiretroviral therapy. Clin. Infect. Dis. 1999; 29: 824–830.
- Singh N, Squier C, Sivek C et al. Determinants of compliance with antiretroviral therapy in patients with human immunodeficiency virus: prospective assessment with implications for enhancing compliance. AIDS Care 1996; 8: 261–269.
- Tucker JS, Burnam MA, Sherbourne CD et al. Substance use and mental health correlates of nonadherence to antiretroviral medications in a sample of patients with human immunodeficiency virus infection. Am. J. Med. 2003; 114: 573–580.
- UNAIDS. 2007 AIDS Epidemic Update, Regional Summary. Geneva: UNAIDS, 2008.
- UNGASS. Country Progress Report, Thailand, Reporting Period January 2006–December 2007. Geneva: UNAIDS, 2008.
- Vyavaharkar M, Moneyham L, Tavakoli A et al. Social support, coping, and medication adherence among HIV-positive women with depression living in rural areas of the southeastern United States. AIDS Patient Care STDs 2007; 21: 667–680.
- Watt MH, Maman S, Earp JA et al. “It's all the time in my mind”: facilitators of adherence to antiretroviral therapy in a Tanzanian setting. Soc. Sci. Med. 2009; 68: 1793–1800.
- Yun LW, Maravi M, Kobayashi JS et al. Antidepressant treatment improves adherence to antiretroviral therapy among depressed HIV-infected patients. J. Acquir. Immune Defic. Syndr. 2005; 38: 432–438.