HIV/AIDS medication adherence factors: inner-city clinic patient's self-reports.

OBJECTIVE: To document common facilitators of, and barriers to, HIV/AIDS medication regimen adherence and to identify facilitators and barriers significantly correlated to attainment of higher vs. lower adherence. DESIGN: Data were collected using semi-structured interviews. SETTING: An outpatient clinic serving as the regional treatment center for HIV disease. PATIENTS: A purposive sample of 57 clinic patients was enrolled and completed the study. MAIN OUTCOME MEASURES: Self-reported adherence was measured using a visual analog scale and specified as higher or lower adherence at the 80% level, the approximate median. RESULTS: Many barriers to adherence were more prevalent in the lower adherence group, including complexity of the medication regimen and experiencing side effects. Lower adherence patients also had more problems with privacy and interference with social life and work or school. Patients in the higher adherence group were more concerned with forgetting as an adherence barrier. In general, social support, motivation to avoid AIDS, perceiving the health care practitioner as a facilitator, knowledge of medications, and keeping schedules were identified as factors enhancing adherence. CONCLUSIONS: The high prevalence of many barriers shows that the health care provider has an important role in patient education and support to accomplish increased adherence. Fear and avoidance behaviors in the lower adherence group contrasted with the increased concern with forgetting in the higher adherence group. Communicating treatment advances with patients may help more patients to address many barriers to higher adherence.