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Author Notes:

Corresponding author: Moka Yoo-Jeong, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA, E-mail: meyoo@emory.edu.

Disclosures: The authors report no real or perceived vested interests that relate to this article that could be construed as a conflict of interest.


Research Funding:

This study was supported by grants: P30 NR 014134, T32 NR012715, and R21 MH086491.


  • Adherence
  • Antiretroviral
  • Depression
  • Gastrointestinal
  • HIV
  • Symptoms

A Structural Equation Model of HIV-related Symptoms, Depressive Symptoms, and Medication Adherence.


Journal Title:

Journal of HIV and AIDS


Volume 2, Number 3


Type of Work:

Article | Final Publisher PDF


Adherence to combined antiretroviral therapy (cART) remains critical in management of HIV infection. This study evaluated depression as a potential mechanism by which HIV-related symptoms affect medication adherence and explored if particular clusters of HIV symptoms are susceptible to this mechanism. Baseline data from a multi-visit intervention study were analyzed among 124 persons living with HIV (PLWH). A bifactor model showed two clusters of HIV-related symptom distress: general HIV-related symptoms and gastrointestinal (GI) symptoms. Structural equation modeling showed that both general HIV-related symptoms and GI symptoms were related to higher levels of depressive symptoms, and higher levels of depressive symptoms were related to lower levels of medication adherence. Although general HIV-related symptoms and GI symptoms were not directly related to adherence, they were indirectly associated with adherence via depression. The findings highlight the importance of early recognition and evaluation of symptoms of depression, as well as the underlying physical symptoms that might cause depression, to improve medication adherence.

Copyright information:

© 2016 Yoo-Jeong M, et al.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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