Coercion or Caring: The Fundamental Paradox for Adherence Interventions for HIV+ People with Mental Illness

AIDS Behav. 2017 Jun;21(6):1530-1539. doi: 10.1007/s10461-016-1517-4.

Abstract

To determine if an escalating HIV treatment adherence intervention would be considered by participants from a caring or coercive perspective, perceived coercion was examined in 238 community-based dually diagnosed individuals (HIV+ and a serious mental illness) randomized to a treatment-as-usual (TAU) control group or preventing AIDS through health for HIV+ persons (PATH+) Intervention that increased intervention intensity when adherence fell below 80 %. Minor differences were observed in perceived coercion between the PATH+ Intervention and Control groups with perceived coercion marginally higher in the PATH+ group. Latent growth curve analyses indicate that perceived coercion was not related to duration of the intervention for either the PATH+ or Control group. The experience of coercion by HIV+ individuals receiving community-based mental health services was not related to the intensity or duration of delivered services.

Keywords: HIV+; Intervention cascade; Perceived coercion; Serious mental illness; Treatment adherence.

MeSH terms

  • Acquired Immunodeficiency Syndrome
  • Adult
  • Coercion*
  • Community Mental Health Services*
  • Empathy*
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • Humans
  • Male
  • Medication Adherence*
  • Mental Disorders / psychology*
  • Mental Disorders / therapy*
  • Middle Aged
  • Perception