Applying an expanded social determinant approach to the concept of adherence to treatment: the case of Colombian women living with HIV/AIDS

Womens Health Issues. Mar-Apr 2011;21(2):177-83. doi: 10.1016/j.whi.2010.09.003. Epub 2010 Dec 22.


Background: The purpose of this study was to explore and analyze social determinants that influence adherence among Colombian women living with HIV/AIDS in poverty conditions.

Methods: A qualitative, descriptive-interpretative study was developed. Forty-seven women participated in five focus group discussions. Also, in-depth interviews with six women were conducted.

Findings: Results showed that women with lower adherence sell their antiretroviral medication to satisfy economic needs, and prioritize the care of their HIV-positive children over their own adherence needs. In contrast, women with higher adherence were found to participate in social support groups offered by nongovernmental organizations.

Conclusion: These findings underscore the need to understand the social determinants that facilitate and/or hinder adherence among women in poverty-associated conditions. Results indicate the need to facilitate access to treatment on a timely and continual basis; provide economic resources, including support to meet basic needs as well as subsidies for transportation to health care centers; and explore mechanism for supporting the care of their offspring.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • Colombia
  • Female
  • Focus Groups
  • HIV Infections / drug therapy*
  • HIV Infections / ethnology
  • HIV Infections / psychology
  • Health Services Accessibility
  • Hispanic or Latino / psychology*
  • Humans
  • Interviews as Topic
  • Medication Adherence / ethnology*
  • Medication Adherence / psychology
  • Middle Aged
  • Poverty* / psychology
  • Qualitative Research
  • Social Environment
  • Social Support*
  • Stress, Psychological
  • Tape Recording
  • Young Adult


  • Anti-Retroviral Agents