Changes in Stress, Substance Use and Medication Beliefs Are Associated with Changes in Adherence to HIV Antiretroviral Therapy

The most commonly cited barriers to HIV treatment adherence include stress, substance use' and medication beliefs. In the current study, researchers used longitudinal techniques to examine the temporal relationship between these barriers and regimen adherence among clients attending treatment adherence support groups in New York state.

In all, 4,155 interview pairs were analyzed across three interview transitions. Multinomial models were created with four-category change-based independent variables (e.g., low stress at both interviews; low stress at interview 1 and high stress at interview 2; high stress at interview 1 and low stress at interview 2; and high stress at both interviews) that predicted a similarly constructed four-category adherence change variable.

“Clients who reported positive changes in stress, substance use or medication beliefs were more likely to change from being nonadherent to being adherent, while clients who reported negative changes were more likely to change from being adherent to being nonadherent,” the authors concluded. “To improve or maintain adherence over time, strategies should be used that facilitate positive changes - and prevent negative changes - in stress, substance use, and medication beliefs.”

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