Why did you decide to stop taking antiretroviral medications?
Presentation
Overview
Overview
Description
Abstract
Background: Findings indicating that dedicated antiretroviral (ARV) medication adherence results in decreased HIV transmission underscore the importance of maintaining adherence. Given the significance of depression, stressful life events, and symptom intensity as factors affecting HIV infected persons we investigated the impact of these variables in discriminating between those who stop medications on the advice of their health care providers and those who decide independently.
Methods: A convenience sample of 2,182 PLHIV was enrolled from HIV sites in Canada, China, Namibia, Puerto Rico, Thailand and the United States. A cross-sectional survey assessed reasons for antiretroviral medication cessation (stopped medications on their own; stopped medications with health care provider (HCP)) depression (CES-D scale), stressors (Stressful Life Events scale), and symptom intensity (SSC scale) for the 110 individuals no longer taking ARVs. Data analyses included descriptive statistics, chi square and t tests.
Results: Participants’ mean age was 43.53 with 70 (64.2%) male, 36 (33%) female and 3 (2.8%) transgender and 56 (51.4%) African American, 20 (18.3 %) White/Anglo, 20 (18.3%) Hispanic, 6 (5.5%) Asian, and 3 (2.8%) Native-American. A greater percentage of individuals (64.5%) stopped ARVs on their own with no significant differences in sociodemographic characteristics and marginally significant differences for depression (p=.052). Several Stressful Life events were significant including: seriously injured (p=.018), major financial problems (p=.049), problems with police (p=.018), rejected by others due to HIV status (p=.033), and family members rejected by others due to HIV status (p=.002). Greater symptom intensity was also associated with greater likelihood to stop medications on their own (p=.014).
Conclusions: Our findings underscore the importance of depression, stressful life events, and symptom intensity in decisions to stop medications without consulting a health care provider. To reduce ARV lack of adherence (a public health issue), health care providers need to attend both to the physical and psychosocial factors affecting their patients.
