Psychosocial Characteristics Associated with Both Antiretroviral Therapy Adherence and Risk Behaviors in Women Living with HIV

• Type of Material: Article
• Authors: Marcia McDonnell Holstad, Emory University; Sydney A. Spangler, Emory University; Melinda K Higgins, Emory University; Safiya George Dalmida, Emory University; Sanjay Sharma, Emory University
• Language: English
• Date: 2016-05-01
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015, Springer Science+Business Media New York.
• Final Published Version (URL): http://dx.doi.org/10.1007/s10461-015-1209-5
• Title of Journal or Parent Work: AIDS and Behavior
• ISSN: 1090-7165
• Volume: 20
• Issue: 5
• Start Page: 1084
• End Page: 1096
• Grant/Funding Information: This study was funded by the National Institutes of Nursing Research/National Institutes of Health (R01NR008094) and in part by the Emory Center for AIDS Research (P30 AI050409).
• Keywords: Self-efficacy; Sexual risk behavior; SEXUAL RISK; Life Sciences & Biomedicine; Motivation; INTRINSIC MOTIVATION; Difficult life circumstances; POSITIVE WOMEN; HIV/AIDS; UNSAFE SEX; Antiretroviral medication adherence; SELF-DETERMINATION; HUMAN-IMMUNODEFICIENCY-VIRUS; Science & Technology; MEDICATION ADHERENCE; ART; Public, Environmental & Occupational Health; VIRAL LOAD; Biomedical Social Sciences; CONDOM USE; Social Sciences; Social Sciences, Biomedical; SOCIAL SUPPORT
• Research Categories: Health Sciences, Public Health; Health Sciences, Immunology

Abstract

The purpose of this study was to identify key psychosocial characteristics of HIV-infected women who exhibit different levels of both ART adherence and risk behaviors. We analyzed baseline data from 193 predominately African American HIV-infected women participating in a behavioral clinical trial. Women were categorized into high/low groups based on levels of adherence and risky behaviors. There was a significant interaction effect for internal motivation for adherence. Women at high risk for poor health and transmitting HIV (low adherence/high risk group) had the lowest levels of internal motivation and also reported more difficult life circumstances. Gender roles, caretaking and reliance on men for economic and other support may promote external versus internal motivation as well as riskier behaviors in this group. The highest levels of internal motivation were found in those with High Adherence/High Risk behaviors. This group was highly knowledgeable about HIV and had the lowest VL. Compared to others, this group seems to tolerate risky behaviors given their high level of adherence. Adherence and risk reduction behaviors are key to individual and public health. Motivation and risk compensation should be addressed when providing interventions to women living with HIV.