Problems taking pills: understanding HIV medication adherence from a new perspective

Abstract

HIV medication adherence remains a challenge for people taking antiretroviral therapy. In the last decade research in this area has proliferated, yet there is a need for novel research approaches that provide information on the development of successful medication adherence interventions. This study examined several key potential correlates of reasons for missed medication in a diverse sample of people living with HIV/AIDS (PLWHA) from nine cities in the US using an ordinal regression model. Examining the reasons for missed medication in relationship with regimen type, symptom experience, AIDS diagnosis, other health conditions, and social support offers a new approach. Problems taking pills (a factor of five reasons) was significantly associated (p=0.003) with use of a protease inhibitor (PI) regimen. A person taking a PI regimen has a 70% increase of having more problems taking pills versus a non-PI regimen. Symptom experience (odds ratio [OR]: 3.8; 95% confidence interval [CI]: 2.7, 5.2) and other health conditions (OR: 0.7; 95% CI: 0.45, 0.98) were found to be independently associated with problems taking pills. This new perspective may provide a framework for further conceptualizing new analyses that are related to enhancing adherence intervention research and development.

Keywords:

• HIV
• medication adherence
• regimen
• symptom experience
• reasons for missed medication

Acknowledgements

This work was supported in part by NIH Training Grant T32 NR007081, funded by the National Institute of Nursing Research and in part by NIH Training Grant T32 RR023259.

The author would also like to acknowledge the following: Dr Carmen Portillo, Dr William Holzemer, Dr Mallory Johnson, Dr Carol Dawson-Rose; The UCSF International Nursing Network for HIV/AIDS Research and Eric Vittinghoff, UCSF, Epidemiology and Biostatistics Department.