Predictors of medication adherence in high risk youth of color living with HIV

J Pediatr Psychol. 2010 Jul;35(6):593-601. doi: 10.1093/jpepsy/jsp080. Epub 2009 Sep 15.

Abstract

Objective: To test predictors of medication adherence in high-risk racial or ethnic minority youth living with HIV (YLH) using a conceptual model of social cognitive predictors including a continuous measure of motivational readiness.

Methods: Youth were participants in a multi-site clinical trial examining the efficacy of a motivational intervention. Racial-minority YLH (primarily African American) who were prescribed antiretroviral medication were included (N = 104). Data were collected using computer-assisted personal interviewing method via an Internet-based application and questionnaires.

Results: Using path analysis with bootstrapping, most youth reported suboptimal adherence, which predicted higher viral load. Higher motivational readiness predicted optimal adherence, and higher social support predicted readiness. Decisional balance was indirectly related to adherence.

Conclusions: The model provided a plausible framework for understanding adherence in this population. Culturally competent interventions focused on readiness and social support may be helpful for improving adherence in YLH.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • African Americans / psychology
  • Anti-Retroviral Agents / therapeutic use*
  • Chi-Square Distribution
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • HIV Seropositivity / drug therapy*
  • HIV Seropositivity / psychology
  • Humans
  • Male
  • Medication Adherence / psychology*
  • Motivation*
  • Social Support
  • Surveys and Questionnaires
  • Viral Load
  • Young Adult

Substances

  • Anti-Retroviral Agents