Perspectives of middle-aged African-American women in the Deep South on antiretroviral therapy adherence

• Type of Material: Article
• Authors: Margaret DeMoss, Emory University; Loida Bonney, Emory University; Jennifer Grant, Emory University; Robin Klein, Emory University; Carlos Del Rio, Emory University; Judith C. Barker, University of California San Francisco
• Language: English
• Date: 2014-05-04
• Publisher: Taylor & Francis (Routledge): STM, Behavioural Science and Public Health Titles
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Taylor & Francis.
• Final Published Version (URL): http://dx.doi.org/10.1080/09540121.2013.841835
• Title of Journal or Parent Work: AIDS Care
• ISSN: 0954-0121
• Volume: 26
• Issue: 5
• Start Page: 532
• End Page: 537
• Keywords: Science & Technology; Life Sciences & Biomedicine; Biomedical Social Sciences; UNITED-STATES; South; Health Policy & Services; black women; HIV; SEX; HIV/AIDS; HAART; Respiratory System; adherence; COHORT; Psychology; HIV-INFECTED WOMEN; Public, Environmental & Occupational Health; Psychology, Multidisciplinary; CARE; Social Sciences, Biomedical; Social Sciences; Health Care Sciences & Services
• Research Categories: Health Sciences, Public Health; Sociology, Ethnic and Racial Studies; Health Sciences, Rehabilitation and Therapy

Abstract

Despite evidence of stabilization in some areas of the USA, HIV infection in black women is not declining in the Deep South. Using a phenomenological approach to qualitative inquiry, we investigated women's experiences influencing their adherence to highly active antiretroviral therapy (HAART) in an urban setting. Inclusion criteria specified black women who had been aware of their HIV status for at least two years and were engaged in HIV outpatient care. Twelve single face-to-face confidential in-depth semi-structured interviews were conducted from a sample of predominantly middle-aged women retained in care at an HIV clinic in Atlanta, Georgia. Data were analyzed by two independent reviewers and three themes emerged from the group of women's accounts of their experiences. First, sentinel events led to changes in perspective and motivated women to adhere to HAART. Second, recognition that one had the personal strength necessary to cope with HIV fostered adherence. Finally, relationships with healthcare providers especially trust issues surrounding this relationship, impacted adherence both positively and negatively. These findings suggest that HAART adherence is a complex issue among middle-aged urban black women with HIV in the Deep South. Providers caring for this patient population should recognize that sentinel events, personal strength, and positive healthcare relationships are opportunities to improve adherence.