Article

Applying the theory of planned behavior to explore HAART adherence among HIV-positive immigrant Latinos: Elicitation interview results

Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Patient Education and Counseling (Impact Factor: 2.6). 12/2011; 85(3):454-60. DOI: 10.1016/j.pec.2010.12.004
Source: PubMed

ABSTRACT This study explored influences on intention to adhere to highly active antiretroviral therapy (HAART) among immigrant Latinos living with HIV/AIDS in the southeastern USA.
Our community-based participatory research (CBPR) partnership completed individual in-depth interviews with 25 immigrant Latinos, based on the theory of planned behavior (TPB), to explore beliefs toward HAART adherence and HIV testing.
Participants identified (a) seven outcomes of treatment adherence (e.g., "feeling good" and "controlling the virus"), (b) six groups of persons influencing adherence (e.g., family, partner/spouse), and (c) nine impediments to adherence (e.g., appointment scheduling, side effects of treatment). Fear of deportation, perceived costs of services, and barriers to communication emerged as impediments to both HAART adherence and HIV testing.
The findings suggest the utility of TPB in identifying factors to enhance HAART adherence among immigrant Latinos. Future research should explore the extent to which these identified TPB components quantitatively influence adherence intention and immunological and virological outcomes.
Culturally congruent interventions for immigrant Latinos may need to focus on facilitators of adherence, influential referent groups, and destigmatizing HIV/AIDS.

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    • "Patient-related factors are considered as the main reasons for nonadherence . Next to socio-demographic [17] and clinical factors [18], empirical evidence suggests that patients' intention towards adherence is associated with medical adherence behavior in various patient populations [19] [20] [21]. Social cognitive theories have proposed intentions towards medication adherence being the most influential direct predictor of adherence behavior alongside an individual's control beliefs [22]. "
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    • "In fact, language difficulties have been identified as the main communication problem related to immigrants' non-adherence (e.g., Griva et al., 2013; Hakonsen & Toverud, 2011; Vissman et al., 2011). Besides this, some authors (e.g., Traylor, Schmittdiel, Uratsu, Mangione, & Subramanina, 2010) agree that language concordance between patients and health-care providers can be related with better TA, namely in Hispanic-Americans with diabetes. "
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    • "In relation to adherence to treatment regimes among HIV patients, Munro et al [20] reviewed 6 behavioural models applied to promoting adherence in a limited number of studies but found little evidence for effectiveness. Studies in the last 5 years appear to be reiterating the same conclusion with some finding the Theory of Planned Behaviour (TPB) [21] instrumental to enhance adherence [22] whereas others found that only a small fraction of the variance in intention to adhere to antiretroviral therapy was explained by the classic TPB predictor set of attitude, norms and perceived control [23]. Self-regulatory processes were found to mediate between intention and adherence [24]. "
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