Investigating the potentially important role of psychological flexibility in adherence to antiretroviral therapy in people living with HIV. Issue 3 (4th March 2021)

• Record Type: Journal Article
• Authors: Harrison, Anja; Scott, Whitney; Timmins, Liadh; Graham, Christopher D.; Harrison, Anthony M.
• Is Part Of: AIDS care. Volume 33:Issue 3(2021)
• Page Start: 337
• Page End: 346
• Publication Date: 2021-03-04
• Subjects: HIV AIDS -- adherence -- antiretroviral treatment -- psychological flexibility -- acceptance and commitment therapy (ACT); AIDS (Disease) -- Social aspects -- Periodicals; AIDS (Disease) -- Psychological aspects -- Periodicals; AIDS (Disease) -- Patients -- Care -- Periodicals; Acquired Immunodeficiency Syndrome; 362.1969792
• DOI: 10.1080/09540121.2020.1771263
• Languages: English
• ISSNs: 0954-0121

Abstract

ABSTRACT: Antiretroviral therapy (ART) has significantly improved immune health and survival rates in HIV, but these outcomes rely on near perfect adherence. While many psychosocial factors are related to sub-optimal adherence, effectiveness of associated interventions are modest or inconsistent. The Psychological Flexibility (PF) model underlying Acceptance and Commitment Therapy (ACT) identifies a core set of broadly applicable transdiagnostic processes that may be useful to explain and improve non-adherence. However, PF has not previously been examined in relation to ART adherence. Therefore, this cross-sectional study ( n = 275) explored relationships between PF and intentional/unintentional ART non-adherence in people with HIV. Adults with HIV prescribed ART were recruited online. Participants completed online questionnaires assessing self-reported PF, adherence and emotional and general functioning. Logistic regressions examined whether PF processes were associated with intentional/unintentional non-adherence. Fifty-eight percent of participants were classified as nonadherent according to the Medication Adherence Rating Scale, of which 41.0% reported intentional and 94.0% unintentional non-adherence. Correlations between PF and adherence were small. PF did not significantly explain intentional/unintentional non-adherence after controlling for demographic and disease factors. Further clarification of the utility of PF in understanding ART non-adherence is warranted using prospective or experimental designs in conjunction with more objective adherence measures.