Associations among correlates of schedule adherence to antiretroviral therapy (ART): A path analysis of a sample of crack cocaine using sexually active African–Americans with HIV infection

Abstract

Adherence to HIV medication regimens is a function of multiple dimensions including psychological functioning, social support, adherence self-efficacy and optimism regarding treatment. Active substance use can also negatively affect adherence. An understanding of the nature of the associations among the correlates of adherence can better inform the design of interventions to improve adherence. This study developed an exploratory path model of schedule adherence using data from a sample 130 African-American HIV-positive crack cocaine users on highly active antiretroviral therapy (ART). This model was based on the Transactional Model of Stress and Coping developed by Lazarus and Folkman. Following the theory, the effects of psychological distress on schedule adherence were mediated by patients’ relationship with their doctor and optimism towards antiretroviral treatment. Adherence was also associated with patients’ self-efficacy regarding their medical regimen which, in turn, was associated with their social support.

Acknowledgements

The authors wish to acknowledge the helpful comments of Dr. Michael Ross of the University of Texas School of Public Health in the development of this manuscript. This research was supported by a grant from the National Institute on Drug Abuse, R01 DAO14485. The opinions expressed herein are solely those of the authors.