Examination of the Role of Religious and Psychosocial Factors in HIV Medication Adherence Rates

J Relig Health. 2017 Dec;56(6):2144-2161. doi: 10.1007/s10943-017-0377-1.


Optimal adherence to antiretroviral therapy (ART) is associated with favorable HIV outcomes, including higher CD4 cell counts, HIV virus suppression and a lower risk of HIV transmission. However, only 25% of people living with HIV/AIDS (PLWH) in the USA are virally suppressed. Sub-optimal adherence (<90-95%) contributes to antiretroviral resistance and worse medical outcomes, including more rapid progression to AIDS and death. Psychosocial factors and religion/spirituality (R/S) have a significant impact on ART adherence, but the findings are mixed. The purpose of this study was to examine religious and psychosocial correlates and predictors of ≥90% ART adherence in PLWH. A cross-sectional study was conducted with a sample of 292 outpatient PLWH in the Southeastern USA. Participants completed computerized surveys. The mean ART adherence percentage was 80.9% and only about half reported ≥90% adherence. There were statistically significant differences in ART adherence rates based on age, depressive symptom status and frequency of religious attendance and prayer. Praying at least once a day was significantly associated with ≥90% ART adherence (OR = 2.26, 95% CI [1.06-4.79], p < 0.05). Social support satisfaction was also significantly associated with ART adherence (OR = 1.52, 95% CI [1.11-2.08], p < 0.05) and energy/fatigue/vitality (OR = 1.03, 95% CI [1.00-1.05], p < 0.05).

Keywords: Antiretroviral therapy; HIV/AIDS; Medication adherence; Religion; Spirituality.

MeSH terms

  • Anti-HIV Agents / therapeutic use*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology*
  • Humans
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Religion and Medicine*
  • Social Support*
  • Southeastern United States


  • Anti-HIV Agents