Title | The impact of stigma on medication adherence among HIV-positive adolescent and young adult females and the moderating effects of coping and satisfaction with health care. |
Publication Type | Publication |
Year of Publication | 2012 |
Authors | Martinez J, Harper G, Carleton RA, Hosek S, Bojan K, Clum G, Ellen J |
Corporate Authors | Adolescent Medicine Trials Network |
Journal | AIDS Patient Care STDS |
Volume | 26 |
Issue | 2 |
Pagination | 108-15 |
Date Published | 2012 Feb |
ISSN | 1557-7449 |
Keywords | Adaptation, Psychological, Adolescent, Anti-HIV Agents, Cohort Studies, Depression, Female, Health Services Accessibility, HIV Seropositivity, Humans, Medication Adherence, Patient Satisfaction, Quality of Life, Self Efficacy, Social Stigma, Social Support, Surveys and Questionnaires, Young Adult |
Abstract | <p>To explore whether HIV stigma negatively impacts adherence to antiviral medications in HIV-infected adolescent women, moderational analysis was conducted and factors identified that could alter said relationship. Study participants were 178 adolescent females age 15-24, enrolled between 2003-2005, from 5 different cities and 60 provided adherence information. Findings reported by this cohort of 60 adolescent women included: medication adherence, 64.3% reporting adherence at baseline and 45.0% at 12 months; HIV stigma score of 57.60 (standard deviation [SD], 11.83; range, 25-86). HIV stigma was not found to be a significant predictor when binary logit regression was run with medication adherence at 1 year. Using moderational analysis, factors that could moderate stigma's effect on medication adherence was still pursued and identified the following to be significant at 12 months: health care satisfaction (B = -0.020, standard error [SE] = 0.010, p < .05); and Coping (proactive coping strategies [B = 0.012, SE = 0.005, p < .05]; turning to family [B = 0.012, SE = 0.016, p < 0.05]; spiritual coping [B = 0.021, SE = 0.010, p < 0.05]; professional help [B = 0.021, SE = 0.010, p < 0.05]; physical diversions [B = 0.016, SE = 0.007, p < 0.05]). Factors that had no significant moderating effects included: social support measures (mean = 74.9; median = 74.0) and depression score greater than 16 = 43%. We conclude that HIV-infected adolescent women experience HIV stigma and poor adherence over time. Factors like health care satisfaction and coping may minimize stigma's effect on medication adherence. Our findings are tempered by a small sample size and lack of a direct relationship between stigma and adherence on binary logit regression analysis.</p> |
DOI | 10.1089/apc.2011.0178 |
Alternate Journal | AIDS Patient Care STDS |
PubMed ID | 22149767 |
PubMed Central ID | PMC3266519 |
Grant List | U01 HD040533 / HD / NICHD NIH HHS / United States U01 HD040474 / HD / NICHD NIH HHS / United States R01DA14706 / DA / NIDA NIH HHS / United States U01 HD040515 / HD / NICHD NIH HHS / United States U01 HD40533 / HD / NICHD NIH HHS / United States U01 HD040470 / HD / NICHD NIH HHS / United States |