Applying Theory of Planned Behavior to explore HAART adherence among HIV-positive Latino immigrants living in NC: Elicitation interview results

Background: Research has suggested that Latinos living with HIV/AIDS may not trust evidence-based medicine for a variety of reasons including fear that the risks (e.g., stigma, deportation, side effects) associated with evidence-based medicine outweigh its benefits. This mistrust may result in not seeking HIV counseling and testing, longer delays in obtaining medical care after HIV infection, and inadequate levels of HAART adherence.

Methods: The theory of planned behavior (TPB) was applied to understand the influences on the intention of Latino immigrants with HIV/AIDS to adhere to their treatment regimen. Our community-based participatory research (CBPR) partnership completed audio-recorded individual in-depth interviews to identify salient behavioral beliefs, normative beliefs, and control beliefs, and other factors (including trust and mistrust of evidence-based medicine) that may influence adherence to HIV medication.

Results: Latinos with HIV in care (n=15); Latinos with HIV not in care (n=5); and Latinos at increased risk for HIV (n=5) participated. We identified (a) eight outcomes of treatment adherence (including “feeling good” and “controlling the virus”), (b) three groups of persons influencing adherence (including spouse and siblings), and (c) ten impediments to adherence (including lack of permanent address and perceived racism). Trust was identified as influential in each theoretical construct.

Conclusions: These findings suggest the utility of TPB in identifying factors for enhancing treatment outcomes among Latino immigrants with and at increased risk for HIV/AIDS. Further research will explore the extent that trust of evidence-based medicine mediates the effects of these constructs on intention to adhere to HAART.