Accounts for non-adherence to antiviral combination therapies among older HIV-infected adults
While HIV-patient education has emphasized the importance of adherence to antiviral combination therapies, the complexity of current multi-drug regimens, coupled with aversive sideeffects pose significant
threats to adherence. Given that greater non-adherence among older adults is well documented in the general medication adherence literature, older HIV-infected adults may be at elevated risk for non-adherence.
Patient accounts for non-adherence were explored as part of a psychosocial investigation of the experiences of HIV-infected late middle-age and older adults on protease inhibitors. Thematic classification
of the 'accounts' offered for non-adherence according to Scott and Lyman's (1968) typology of justifications and excuses allowed for the identification of the perceived motives for intentional versus unintentional
non-adherence. Excuses offered for non-adherence included: (1) intolerable side-effects, (2) unusually busy lives, (3) unavailability of food when needed, (4) tiredness, and (5) the need to conceal medications
to avoid stigma/exposure of HIV status. Common justifications for non-adherence were: (1) some flexibility won't hurt me, (2) no one really knows the real impact of non-adherence, (3) if my viral load is
'undetectable' then strict adherence is not necessary, and (4) strict adherence is an unattainable standard. In contrast to expectations, few age-related reasons for non-adherence were identified. These
understandings for their non-adherence provide a crucial basis for understanding new paths for promoting adherence to combination antiviral therapies.
Document Type: Research Article
Publication date: 01 February 2000
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