224351 Influence of Stigma, Depression, and Medication Self-efficacy on Adherence with Anti-retroviral Therapy in Older Adults Living with HIV/AIDS

Wednesday, November 10, 2010 : 1:30 PM - 1:45 PM

Richard Fortinsky, PhD , Center on Aging, University of Connecticut Health Center, Farmington, CT
Elizabeth Anderson, PhD , School of Nursing, University of Connecticut, Storrs, CT
Charles A. Emlet, PhD, ACSW , Social Work Program, University of Washington, Tacoma, Tacoma, WA
Leslie Golay , Department of Psychology, University of Connecticut, Storrs, CT
Background: Adults aged >50 years (older adults by CDC definition) represent a growing proportion of the U.S. population living with HIV/AIDS. Adherence to anti-retroviral therapy (ART), required to improve immune system function, is especially important for older adults living with HIV/AIDS due to increased likelihood of additional medical conditions that could compromise health status. Stigma, depression, and medication self-efficacy are known to influence ART adherence in younger adults, but these influences are poorly understood in older adults; therefore, we examined these interrelationships in older adults (OA) living with HIV/AIDS.

Methods: In-person interviews were conducted with OA living with HIV/AIDS recruited from clinics and community-based organizations. Dependent variable was whether adherent (> 90%) or not with ART, based on the AIDS Clinical Trials Group measure. Independent variables included: 32-item Revised HIV Stigma Scale; 26-item HIV medication Self-Efficacy Scale (higher score=greater self-efficacy); 20-item Center for Epidemiological Studies-Depression Scale.

Results: 72 subjects completed interviews (34% female; mean age=55, range=50-71; 36% African-American, 32% Caucasian, 25% Hispanic). 74% of subjects were adherent with ART. Adherence was positively associated with medication self-efficacy (r = 0.33; p=.008), but adherence was not associated with depression nor with stigma. However, medication self-efficacy was negatively associated with both stigma (r = -.27; p=.035) and with depression (r = -.32; p=.008).

Conclusions: Only medication self-efficacy was directly associated with ART adherence, but medication self-efficacy was influenced by perceived stigma and depression. Public health interventions to maximize medication adherence in OA living with HIV/AIDS must account for psychological factors affecting medication self-efficacy.

Learning Areas:
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs

Learning Objectives:
Discuss how medication adherence is influenced by perceived stigma, depression, and medication self-efficacy in older adults living with HIV/AIDS.

Keywords: HIV/AIDS, Aging

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I co-directed all aspects of the study upon which the results reported in this abstract are based.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.