Psychological model of ART adherence behaviors in persons living with HIV/AIDS in Mexico: a structural equation analysis

Rev Saude Publica. 2017 Sep 4:51:81. doi: 10.11606/S1518-8787.2017051006926.

Abstract

Objective: The objective of this study has been to test the ability of variables of a psychological model to predict antiretroviral therapy medication adherence behavior.

Methods: We have conducted a cross-sectional study among 172 persons living with HIV/AIDS (PLWHA), who completed four self-administered assessments: 1) the Psychological Variables and Adherence Behaviors Questionnaire, 2) the Stress-Related Situation Scale to assess the variable of Personality, 3) The Zung Depression Scale, and 4) the Duke-UNC Functional Social Support Questionnaire. Structural equation modeling was used to construct a model to predict medication adherence behaviors.

Results: Out of all the participants, 141 (82%) have been considered 100% adherent to antiretroviral therapy. Structural equation modeling has confirmed the direct effect that personality (decision-making and tolerance of frustration) has on motives to behave, or act accordingly, which was in turn directly related to medication adherence behaviors. In addition, these behaviors have had a direct and significant effect on viral load, as well as an indirect effect on CD4 cell count. The final model demonstrates the congruence between theory and data (x2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance.

Conclusions: The results of this study support our theoretical model as a conceptual framework for the prediction of medication adherence behaviors in persons living with HIV/AIDS. Implications for designing, implementing, and evaluating intervention programs based on the model are to be discussed.

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy
  • Acquired Immunodeficiency Syndrome / immunology
  • Acquired Immunodeficiency Syndrome / psychology*
  • Adult
  • Aged
  • Anti-HIV Agents / therapeutic use
  • CD4 Lymphocyte Count / statistics & numerical data
  • Cross-Sectional Studies
  • Decision Making
  • Female
  • Frustration
  • Humans
  • Male
  • Medication Adherence / psychology*
  • Medication Adherence / statistics & numerical data
  • Mexico
  • Middle Aged
  • Models, Psychological*
  • Social Support
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Anti-HIV Agents