Abstract/Details

The Impact of Comorbidities on Medication Adherence among People Living with HIV


2010 2010

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Abstract (summary)

Given the major public health implication of HIV medication non-adherence, it is crucially important to determine and understand the factors associated with adherence. Previous research has recognized individual, psychosocial, and environmental factors as important barriers to medication adherence in people living with HIV/AIDS; however, little attention has been given to the effect of comorbidities, as a patient factor, and the significant challenges created by multiple diseases and treatment regimens on HIV medication adherence. Poor understanding of the role of comorbidities in medication adherence limits the ability to treat people living with HIV effectively. This study attempted to fill the gap in the literature by investigating three aims. The first aim is the assessment of the patterns of comorbidity across racial and ethnic groups who are HIV positive and compared them to the patterns of those who are HIV negative. The second aim is the determination of the association between HIV medication adherence and comorbidities. The third aim is the analysis of how social and medical characteristics mediate the association between comorbidities and HIV medication adherence.

This study employed a secondary data analysis of the Veterans Aging Cohort Study (VACS) to examine the patterns of comorbidity as well as the direct and mediate relationship between comorbid disease and HIV medication adherence. The study findings show that comorbidity patterns are related to race rather than HIV status, which may be an indication of disparities within society and the healthcare system. Further, HIV-infected veterans with cardiovascular disease had higher HIV medication adherence than HIV-infected veterans without cardiovascular disease whereas veterans with substance abuse were less adherent than HIV-infected veterans without substance abuse. Finally, social support and medical characteristics did not mediate the relationship between cardiovascular disease, substance abuse, and adherence.

Although this study found partial support of proposition that there is an association between comorbidity and HIV medication adherence, this may be a reflection of the quality of care received by veterans at the VA. Future research would need to be done to determine the association between comorbidity and HIV medication adherence outside of the VA healthcare system.

Indexing (details)


Subject
Behavioral psychology;
Public health
Classification
0384: Behavioral psychology
0573: Public health
Identifier / keyword
Health and environmental sciences; Psychology; Antiretroviral medication; Comorbidities; HIV/AIDS; Medication adherence; Veterans
Title
The Impact of Comorbidities on Medication Adherence among People Living with HIV
Author
Webster, Tashonna R.
Number of pages
138
Publication year
2010
Degree date
2010
School code
0056
Source
DAI-B 72/10, Dissertation Abstracts International
Place of publication
Ann Arbor
Country of publication
United States
ISBN
9781124799643
Advisor
Singer, Merrill
University/institution
University of Connecticut
University location
United States -- Connecticut
Degree
Ph.D.
Source type
Dissertations & Theses
Language
English
Document type
Dissertation/Thesis
Dissertation/thesis number
3464250
ProQuest document ID
884270235
Copyright
Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works.
Document URL
http://search.proquest.com/docview/884270235
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