Three types of self-efficacy associated with medication adherence in patients with co-occurring HIV and substance use disorders, but only when mood disorders are present

Figures & data

Table 1 Participant characteristics at baseline interview (n = 154)

	Participants (n)	Proportion of sample
Gender
Male	98	0.64
Female	55	0.36
Transgender	1	0.01
Age in years, mean, median (range)	45.0, 45.5 (26, 64)
Race
African American	126	0.82
Caucasian	20	0.13
Multiracial	8	0.05
Hispanic ethnicity	3	0.02
Education
1–11 years	47	0.30
12–15 years	87	0.56
16 years	20	013
Employed or volunteer	20	013
Monthly income, median (range)	$735 ($0, $14,177)
Mood disorder
Any probable mood disorder	98	0.64
PHQ-9 depression	68	0.44
HADS-A anxiety	81	0.53
ASI alcohol score (scale range 0–1), mean, median (range)	0.097, 0.010 (0, 0.677)
Daily alcohol use in past 30 days	8	0.05
ASI drug score (scale range 0–1), mean, median (range)	0.063, 0.028 (0.025, 0.279)
Substance use in past 30 days
Any substance	82	0.53
Cocaine or crack	59	0.38
Marijuana or hashish	34	0.22
Heroin	3	0.02
Injected any type of illicit drug	1	0.01
HIV self-efficacy (scale range 0–4), median (range)
Combined	2.5 (0.6, 4)
Communication	4.0 (0.8, 4)
Getting support	2.4 (0, 4)
Managing mood	2.1 (0, 4)
Complete adherence	94	0.61
CASE Adherence Index (scale range 0–13), mean, median (range)	8.8, 9.5 (2, 13)
CASE Adherence Index, standardized (mean = 50, SD = 10), median (range)	51.0 (29.8, 62.4)
CASE visual analog score, mean, median (range)	92.6, 100 (20, 100)

Notes: Sample included all participants who reported currently taking HIV medication and completed the following baseline interview measures: self-efficacy, adherence with HIV medication, alcohol and drug use severity, depression, anxiety, physical health, gender, age, race, and education.

Abbreviations: ASI, Addiction Severity Index-Lite; HADS-A, Hospital Anxiety and Depression Scale-Anxiety; HIV, human immunodeficiency syndrome; PHQ-9, Patient Health Questionnaire; CASE, Center for Adherence Support Evaluation.

Table 2 Association between self-efficacy and adherence with HIV medication in multivariable models, with depression and anxiety included as continuous control variables, with each model using a different type of self-efficacy

	Model 1 Combined self-efficacy	Model 2 Communication self-efficacy	Model 3 Getting support self-efficacy	Model 4 Managing mood self-efficacy
Self-efficacy score	3.07*** (0.79, 5.35)	2.58** (0.38, 4.77)	1.96** (0.29, 3.62)	1.66* (−0.11, 3.42)
Male gender	−2.07 (−5.44, 1.30)	−1.87 (−5.26, 1.51)	−1.99 (−5.38, 1.40)	−2.05 (−5.46, 1.36)
African-American	−0.22 (−4.71, 4.26)	0.64 (−3.88, 5.16)	−0.04 (−4.55, 4.46)	−0.28 (−4.84, 4.28)
Age (divided by 5 years)	−0.09 (−1.20, 1.02)	−0.15 (−1.26, 0.97)	−0.09 (−1.21, 1.03)	−0.16 (−1.29, 0.96)
Years of education	0.86** (0.19, 1.53)	0.95*** (0.27, 1.62)	0.91*** (0.23, 1.58)	0.88** (0.20, 1.56)
Alcohol use severity score	−3.28 (−15.10, 8.53)	−4.20 (−16.09, 7.69)	−3.15 (−15.04, 8.73)	−3.25 (−15.22, 8.71)
Drug use severity score	−16.95 (−45.38, 11.47)	−26.30* (−54.82, 2.22)	−17.03 (−45.70, 11.63)	−17.86 (−46.75, 11.03)
Physical health ranking	−0.08 (−1.64, 1.48)	−0.06 (−1.63, 1.51)	0.05 (−1.51, 1.62)	−0.01 (−1.58, 1.57)
Depression score (PHQ-9)	0.15 (−0.23, 0.52)	0.05 (−0.31, 0.42)	0.10 (−0.28, 0.47)	0.11 (−0.27, 0.49)
Anxiety score (HADS-A)	−0.33 (−0.79, 0.14)	−0.35 (−0.82, 0.12)	−0.40* (−0.87, 0.06)	−0.34 (−0.82, 0.13)

Notes: n = 154. Coefficients and 95% confidence intervals are reported. Age was divided by 5 years to increase the scale of the coefficient above 0.001 and facilitate interpretation.

*** P < 0.01;

** P < 0.05;

* P < 0.1.

Abbreviations: HADS-A, Hospital Anxiety and Depression Scale-Anxiety; HIV, human immunodeficiency syndrome; PHQ-9, Patient Health Questionnaire.

Table 3 Association between self-efficacy and adherence in the absence or presence of any depression or anxiety in multivariate models, with depression and anxiety included as a composite dichotomous variable interacting with self-efficacy

	Model 5 Combined self-efficacy	Model 6 Communication self-efficacy	Model 7 Getting support self-efficacy	Model 8 Managing mood self-efficacy
Self-efficacy if client has any mood disorder	4.06*** (1.54, 6.57)	3.85*** (1.49, 6.22)	2.76*** (0.80, 4.72)	2.22** (0.22, 4.21)
Self-efficacy if client has no mood disorder	1.34 (−2.22, 4.89)	−1.63 (−6.63, 3.38)	0.60 (−2.18, 3.38)	1.21 (−1.38, 3.81)
Male gender	−1.85 (−5.18, 1.48)	−2.00 (−5.35, 1.35)	−1.73 (−5.09, 1.62)	−1.74 (−5.12, 1.64)
African-American	−0.12 (−4.59, 4.36)	1.06 (−3.39, 5.52)	0.14 (−4.36, 4.63)	−0.22 (−4.79, 4.36)
Age (divided by 5 years)	−0.11 (−1.23, 1.02)	−0.16 (−1.27, 0.96)	−0.12 (−1.25, 1.02)	−0.15 (−1.29, 0.99)
Years of education	0.78** (0.12, 1.43)	0.93*** (0.27, 1.59)	0.78** (0.12, 1.44)	0.78** (0.11, 1.44)
Alcohol use severity score	−5.26 (−16.84, 6.32)	−6.93 (−18.54, 4.68)	−5.16 (−16.83, 6.51)	−5.00 (−16.77, 6.78)
Drug use severity score	−16.72 (−45.15, 11.71)	−27.00* (−55.21, 1.20)	−17.45 (−46.30, 11.40)	−16.28 (−45.20, 12.64)
Physical health ranking	−0.23 (−1.74, 1.27)	0.03 (−1.47, 1.53)	−7.45 (−16.81, 1.91)	−0.13 (−1.66, 1.40)
Presence of mood disorder	−1.48 (−5.15, 2.18)	−2.24 (−5.74, 1.26)	−2.15 (−5.69, 1.39)	−1.47 (−5.23, 2.29)

Notes: n = 154. Coefficients and 95% confidence intervals are reported. Age was divided by 5 years to increase the scale of the coefficient above 0.001 and facilitate interpretation.

*** P < 0.01;

** P < 0.05;

* P < 0.1.