Improving medication adherence in African-American women living with HIV/AIDS: Leveraging the provider role and peer involvement

ABSTRACT

African–American women continue to be disproportionately affected by HIV-related morbidity and mortality. To address the burden of HIV/AIDS among this at-risk population, there is need to gain a better understanding of the factors that influence and affect their care-seeking behavior and specifically adherence to antiretroviral treatment. A preliminary qualitative study was conducted with a sample of the target population (n = 10) using grounded theory as the methodological approach. Similarly, 21 healthcare providers – physicians, pharmacists, nurses, and case managers – were then interviewed. A thematic analysis of the transcripts compared care-provider perceptions and narrated experiences with those from the patient participants. Themes related to patient care perceived to enhance medication adherence included (1) provider–patient relationship; (2) holistic and patient-centered care; (3) adequacy of patient education and counseling; (4) modeling adherence behavior; and (5) motivation. Two intervention strategies are proposed – Peer educators as an integral part of the care team and Patient Advisory Groups as a feedback mechanism to enhance effective delivery of patient care in the target population. This exploratory research lays a foundation for the design of targeted interventions to improve linkage to care and enhance medication adherence in African-American women living with HIV/AIDS.

KEYWORDS:

• HIV/AIDS
• African–American women
• medication adherence
• healthcare provider
• peer educator

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

This work was supported by funding from the Schlumberger Faculty for the Future Fellowship and the Sheri Aversa Dissertation Completion Grant.