Longitudinal study of mental health and psychosocial predictors of medical treatment adherence in mothers living with HIV disease

AIDS Patient Care STDS. 2003 Aug;17(8):407-16. doi: 10.1089/108729103322277420.


Cross-sectional studies to date that examine psychosocial correlates of antiretroviral adherence have insufficiently addressed the challenges of long-term adherence. This longitudinal study examined mental health, substance abuse, and psychosocial predictors of long-term adherence to antiretroviral medications and medical appointments among HIV-seropositive mothers recruited from an infectious disease clinic of a large urban medical center. Individual interviews were conducted at baseline and two follow-up points, 8 to 18 months after enrollment. Based on a model of health behavior, we examined psychiatric and psychosocial predictors of adherence to antiretroviral medications and medical appointments over time. Presence of a psychiatric disorder, negative stressful life events, more household members, and parenting stress were significantly associated with both missed pills and missed medical appointments at follow-up. Baseline substance abuse was associated with missed pills at follow-up and lack of disclosure to family members at baseline was associated with missed medical appointments at follow-up. These findings suggest that interventions that integrate mental health, substance abuse and medical care may be important to improving the medical adherence and health of HIV-seropositive women, particularly in multistressed populations with substantial caregiving and other life demands.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology*
  • Humans
  • Interviews as Topic
  • Longitudinal Studies
  • Mental Disorders / complications
  • Mothers*
  • New York City
  • Patient Compliance*
  • Urban Health


  • Anti-HIV Agents