Rates and correlates of HIV treatment adherence among late middle-aged and older adults living with HIV disease

A growing number of older adults in the USA are contracting new HIV infections, and more persons living with HIV are living longer due to medical treatment advances. New treatments for HIV disease can improve immune functioning and decrease AIDS-related mortality. However, older persons living with HIV may not respond well to treatment and may experience difficulties adhering to complex medication regimens. One hundred and thirteen late middle-aged and older adults living with HIV (aged 47-69 years) were administered measures of demographic, medical and psychological characteristics. Eighty-four of these patients were currently prescribed antiretroviral medication for treatment of HIV, and this sub-set of participants completed brief self-report measures of medication adherence. Nearly one-third (31%) of older adults reported skipping medication doses in the past week. Education level, satisfaction with patient-provider relationships, physical wellbeing, alcohol use, perceptions of life stressor burden, anxiety and somatization distinguished patients reporting consistent versus inconsistent adherence. Less education, poorer relationships with physicians, greater alcohol use and higher levels of somatization uniquely predicted adherence problems in a multivariate model. Reasons for nonadherence most frequently cited by older adults are presented and recommendations are offered regarding adherence-related domains that should be monitored and addressed among older adults receiving HIV care.