Intentionality of medication nonadherence among individuals living with HIV/AIDS in Hong Kong

Phoenix Kit Han Mo (1) , Winnie W. S. Mak (2)

1 Institute of Work, Health and Organisations
2 Psychology

Adherence to antiretroviral therapy is essential to treatment success for individuals living with HIV/AIDS. Despite the wealth of studies in examining antiretroviral nonadherence, few have distinguished between intentional and unintentional nonadherence. The present study attempted to identify factors associated with adherence, intentional nonadherence, and unintentional nonadherence among HIV+ individuals using a longitudinal design. Dietary instructions and medication schedule were also included to measure the subtleties of antiretroviral adherence. One hundred and two HIV+ patients who were under antiretroviral therapy were recruited in an outpatient clinic in Hong Kong at baseline and 6 months follow-up. Using the conventional adherence rate, only 12 (11.8%) of participants reported having missed/ altered medication in the past four days. However, using a more comprehensive assessment, only 27 (26.5%) of participants were classified as adherers. Results showed that adherers were significantly older and had higher adherence self-efficacy than those who were unintentional or intentional nonadherers. Participants classified as unintentional nonadherers had longer length of diagnosis and started medication longer than adherers and intentional nonadherers. Participants classified as intentional nonadherers had worse mental health, higher level of self-stigma, and reported higher score in avoidant coping than adherers and unintentional nonadherers. They also scored higher in physical symptoms than adherers. Findings highlight the importance of a reliable, comprehensive measurement for adherence and extend on previous adherence literature that intentional and unintentional nonadherence are separate entities and are associated with different factors. Future research should understand the intentions behind nonadherence and this would serve as an important guide in the development of interventions aimed at improving antiretroviral adherence for HIV+ patients.

Mots clés: Life Sciences

Phoenix Kit Han Mo, Winnie W. S. Mak. Intentionality of medication nonadherence among individuals living with HIV/AIDS in Hong Kong. AIDS Care, 2009, 21 (06), pp.785-795. ⟨10.1080/09540120802511968⟩. ⟨hal-00513475⟩