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Titolo:
Trust and the acceptance of and adherence to antiretroviral therapy
Autore:
Altice, FL; Mostashari, F; Friedland, GH;
Indirizzi:
Yale Univ, AIDS Program, Sch Med, New Haven, CT 06510 USA Yale Univ New Haven CT USA 06510 rogram, Sch Med, New Haven, CT 06510 USA
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
fascicolo: 1, volume: 28, anno: 2001,
pagine: 47 - 58
SICI:
1525-4135(20010901)28:1<47:TATAOA>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
INJECTION-DRUG USERS; HUMAN-IMMUNODEFICIENCY-VIRUS; HIV-INFECTED PATIENTS; AIDS CLINICAL-TRIALS; MEDICATION ADHERENCE; SELF-REPORT; ZIDOVUDINE ADHERENCE; PROTEASE INHIBITORS; AFRICAN-AMERICANS; HEALTH BELIEFS;
Keywords:
adherence; antiretroviral therapy; HIV/AIDS; trust; prisoners; directly observed therapy; social isolation; health beliefs; substance abuse;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
77
Recensione:
Indirizzi per estratti:
Indirizzo: Altice, FL Yale Univ, AIDS Program, Sch Med, 135 Coll St,Suite 323, New Haven, CT 06510 USA Yale Univ 135 Coll St,Suite 323 New Haven CT USA 06510 6510 USA
Citazione:
F.L. Altice et al., "Trust and the acceptance of and adherence to antiretroviral therapy", J ACQ IMM D, 28(1), 2001, pp. 47-58

Abstract

Background: Antiretroviral therapy (ART) has resulted in reduced AIDS incidence and mortality. Socially marginalized individuals with HIV infection, particularly injection drug users (IDUs), have received less ART and derived less benefit than others. Little is known about the therapeutic process necessary to promote acceptance of and adherence to ART among marginalized HIV-infected populations. We report on the correlates of both acceptance of and adherence to ART among HIV infected prisoners, most of whom are IDUs. Design: Using a cross-sectional survey design within four ambulatory prison HIV clinics, 205 HIV-infected prisoners eligible for ART were recruited between March and October 1996. Measurements: Detailed interviews were conducted that included personal characteristics, health status and beliefs, and validated standardized scalesmeasuring depression, health locus of control, social desirability and trust in physician, medical institutions and society. Acceptance and adherencewere documented by self-report and validated for a subset by pharmacy review. Clinical information was obtained from standardized chart review. Adherence was defined as having taken greater than or equal to 80% of ART. Results: The acceptance of (80%) and adherence to (84%) ART among this group of prisoners was high. Multiple regression models demonstrated that correlates of acceptance of and adherence to ART differed. Acceptance was associated with trust in physician (8% increase for each unit increase with trust in physician scale) and trust in HIV medications (threefold reduction forthose mistrustful of medication). Side effects (OR = 0.09), social isolation (OR = 0.08), and complexity of the antiretroviral regimen (OR = 0.33) were associated with decreased adherence. The prevalence of health beliefs suggesting an adverse relationship between ART and drugs of abuse was high (range 59 to 77%). Adherence did not differ among those receiving directly observed therapy (82%) or self-administration (85%). Conclusions: ART can be successfully administered within a correctional setting. Trust and the therapeutic relationship between patient and physicianremain central in the ART initiation process. Characteristics of the therapeutic agents and the degree of social isolation predict adherence. These results may inform the design of interventions to improve both acceptance ofand adherence to ART particularly among marginalized populations who have not derived full benefit from these potent new therapies.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 06:32:09