
The Influence of
Cultural, Psychological and Substance Use Factors on
Medication Adherence Among Persons Living With HIV/AIDS
Investigator: Elizabeth C. Pomeroy, Ph.D.
With the advent of the new antiretroviral medications for persons living with HIV/AIDS, problems with medication adherence have become a focus of attention among professionals. Studies indicate that non-adherence rates among HIV positive patients on HAART range from 26-95% (Avants, Margolin, Warburton, Hawkins, & Shi, 2001; Aversa & Kimberlin, 1996; Ickovics & Meade, 2002; Spire, Duran, Souville, et al., 2002). The primary goal of the proposed study is to examine cultural, psychological and substance use factors as they relate to and affect medication adherence among HIV positive clients. The Informational-Motivational-Behavioral Skills Model (Fisher & Fisher, 1993) will be utilized as the basic framework for this study. However, the model will be examined utilizing other factors not currently focused on in the current model. The specific aims of this preliminary study are as follows:
1. To analyze existing data on cultural factors, psychosocial factors, substance use and medication adherence of 225 HIV positive men and women in the Austin area collected from a survey in Spring, 2002;
2. Based on this analysis, to refine the survey questionnaire and conduct a second survey in San Antonio with a sample of approximately 400-450 participants;
3. To analyze the results of the San Antonio survey and assess the predictors and correlates of medication adherence.
The ultimate objective of this project is to develop a causal model of factors leading to medication adherence utilizing structural equation modeling techniques. This model will form the underpinning for the design and assessment of a culturally sensitive intervention to enhance medication adherence skills for HIV positive clients on antiretroviral medication.