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

AIDS Patient Care STDS. 2012 Feb;26(2):108-15. doi: 10.1089/apc.2011.0178. Epub 2011 Dec 7.

Abstract

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.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Anti-HIV Agents / therapeutic use*
  • Cohort Studies
  • Depression / epidemiology
  • Depression / psychology*
  • Female
  • HIV Seropositivity / drug therapy
  • HIV Seropositivity / epidemiology
  • HIV Seropositivity / psychology*
  • Health Services Accessibility
  • Humans
  • Medication Adherence / psychology*
  • Medication Adherence / statistics & numerical data
  • Patient Satisfaction*
  • Quality of Life
  • Self Efficacy
  • Social Stigma*
  • Social Support
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Anti-HIV Agents