Hawkins, A;
Evangeli, M;
Sturgeon, K;
Le Prevost, M;
Judd, A;
(2016)
Episodic medication adherence in adolescents and young adults with perinatally acquired HIV: a within-participants approach.
AIDS Care
, 28
pp. 68-75.
10.1080/09540121.2016.1146210.
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Abstract
Due to the success of antiretroviral (ART) medications, young people living with perinatally acquired HIV (PHIV+) are now surviving into adolescence and young adulthood. Understanding factors influencing ART non-adherence in this group is important in developing effective adherence interventions. Most studies of ART adherence in HIV-positive populations assess differences in adherence levels and adherence predictors between participants, over a period of time (global adherence). Many individuals living with HIV, however, including PHIV+ young people, take medication inconsistently. To investigate this pattern of adherence, a within-participants design, focussing on specific episodes of adherence and non-adherence, is suitable (episodic adherence). A within-participants design was used with 29 PHIV+ young people (17 female, median age 17 years, range 14–22 years), enrolled in the UK Adolescents and Adults Living with Perinatal HIV cohort study. Participants were eligible if they could identify one dose of medication taken and one dose they had missed in the previous two months. For each of the two episodes (one adherent, one non-adherent), behavioural factors (whom they were with, location, routine, day, reminders) and psychological factors at the time of the episode (information about medication, adherence motivation, perceived behavioural skills to adhere to medication – derived from the Information-Motivation-Behavioural Skills (IMB) Model – and affect) were assessed in a questionnaire. Non-adherence was significantly associated with weekend days (Friday to Sunday versus Monday to Thursday, p = .001), lack of routine (p = .004), and being out of the home (p = .003), but not with whom the young person was with or whether they were reminded to take medication. Non-adherence was associated with lower levels of behavioural skills (p < .001), and lower positive affect (p = .005). Non-adherence was not significantly associated with negative affect, information about ART, or ART motivation. The use of situationally specific strategies to enhance adherence in young people who take their medication inconsistently is proposed.
| Type: | Article |
|---|---|
| Title: | Episodic medication adherence in adolescents and young adults with perinatally acquired HIV: a within-participants approach |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1080/09540121.2016.1146210 |
| Publisher version: | http://dx.doi.org/10.1080/09540121.2016.1146210 |
| Language: | English |
| Additional information: | © 2016 The Author(s). Published by Taylor & Francis. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/Licenses/by-nc-nd/ 4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. |
| Keywords: | Life Sciences & Biomedicine, Health Policy & Services, Public, Environmental & Occupational Health, Psychology, Multidisciplinary, Respiratory System, Social Sciences, Biomedical, Health Care Sciences & Services, Psychology, Biomedical Social Sciences, young adult, Antiretroviral, perinatal, adolescent, adherence, BEHAVIORAL SKILLS MODEL, PATIENT-RELATED RISKS, ANTIRETROVIRAL THERAPY, INFECTED YOUTH, UNITED-STATES, NONADHERENCE, MOTIVATION, BARRIERS, PREVALENCE, SYMPTOMS |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10049552 |
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