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.

TitleThe 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 TypePublication
Year of Publication2012
AuthorsMartinez J, Harper G, Carleton RA, Hosek S, Bojan K, Clum G, Glum G, Ellen J
Corporate AuthorsAdolescent Medicine Trials Network
JournalAIDS Patient Care STDS
Volume26
Issue2
Pagination108-15
Date Published2012 Feb
ISSN1557-7449
KeywordsAdaptation, 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>

DOI10.1089/apc.2011.0178
Alternate JournalAIDS Patient Care STDS
PubMed ID22149767
PubMed Central IDPMC3266519
Grant ListU01 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