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Patients' perceptions of highly active antiretroviral therapy in relation to treatment uptake and adherence: the utility of the necessity-concerns framework

journal contribution
posted on 2023-06-08, 10:31 authored by Robert Horne, Vanessa Cooper, Grace Gellaitry, Heather Leake Date, Martin Fisher
Objective: To test the utility of the necessity-concerns framework in predicting highly active antiretroviral therapy (HAART) uptake and adherence. Methods: This was a prospective follow-up study. Consecutive patients who were not currently receiving HAART were referred by their HIV physician. Immediately after a recommendation of HAART, patients completed the Beliefs about Medicines Questionnaire assessing their perceptions of personal necessity for HAART and concerns about potential adverse effects. The influence of these beliefs on the decision to accept or decline HAART and adherence 12 months later were assessed. Results: One hundred fifty-three participants were given a recommendation of HAART, and 136 (88.9%) returned completed questionnaires. Thirty-eight participants (28%) initially rejected the treatment offer. Uptake of HAART was associated with perceptions of personal necessity for treatment (odds ratio [OR] = 7.41, 95% confidence interval [CI]: 2.84 to 19.37) and concerns about potential adverse effects (OR = 0.19, 95% CI: 0.07 to 0.48). There was a significant decline in adherence over time. Perceived necessity (OR = 2.19, 95% CI: 1.02 to 4.71) and concerns about adverse effects (OR = 0.45, 95% CI: 0.22 to 0.96), elicited before initiating HAART, predicted subsequent adherence. These associations were independent of clinical variables and depression. Conclusions: The necessity-concerns framework is a useful theoretic model for understanding patient perspectives of HAART and predicting uptake and adherence, with implications for the design of evidence-based interventions.

History

Publication status

  • Published

Journal

Journal of Acquired Immune Deficiency Syndromes

ISSN

1525-4135

Publisher

Lippincott, Williams & Wilkins

Issue

3

Volume

45

Page range

334-41

Department affiliated with

  • BSMS Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2012-02-21

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