Unmet core needs for self-determination in HIV-infected women of color in medical care

ABSTRACT

The levels of satisfaction of the core self-determination needs (relatedness, autonomy and competence) among HIV-infected women of color as well as the association between need fulfillment and patient characteristics were examined. Having less than a high-school education was associated with lowest need satisfaction: autonomy (β = −1.90; 95%CI = −3.20, −0.60), relatedness (β = −2.70; 95%CI = −4.30, −1.10) and competency (β = −2.50; 95%CI = −3.60, −1.30). Each additional point increase in affective symptoms of depression was associated with decrements in need satisfaction (−.61 autonomy, −.68 relatedness and −.59 competency). Relatedness satisfaction was lower with higher responses on all three measures of violence (psychological abuse: β = −0.13, 95%CI = −0.19 to −0.07; adult traumatic experiences: β = −0.24, 95%CI = −0.35 to −0.13 and childhood traumatic experiences: β = −0.24, 95%CI = −0.40 to −0.08). Interventions that address core self-determination needs, and the characteristics that influence them, may enhance the motivation for self-care of HIV-infected women.

KEYWORDS:

• Women-of-color
• HIV
• autonomy
• relatedness
• competence
• retention-in-care
• self-determination theory

Acknowledgements

This study was conducted with the approval of the Institutional Review Boards of the participating institutions. The authors also acknowledge the clinic staff, providers and patients for their invaluable contributions to this research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Health Resources and Services Administration.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

E. B. Quinlivan http://orcid.org/0000-0002-1213-8707

Additional information

Funding

This research was supported by funds from Health Resources and Services Administration Special Projects of National Significance Initiative: Enhancing Engagement and Retention in Quality HIV Care for Women of Color (HA15148) and the Center of AIDS Research at the University of North Carolina at Chapel Hill (P30-AI50410); National Institutes of Health.