HIV/AIDS Patients’ Perspectives on Adhering to Regimens Containing Protease Inhibitors

Authors


Dr. Stone: Division of General Internal Medicine, Department of Medicine, Memorial Hospital of Rhode Island, Brown University School of Medicine, 111 Brewster St., Pawtucket, RI 02860.

Abstract

OBJECTIVE:

To gather qualitative data regarding HIV/AIDS patients’ perspectives about HIV-1 protease inhibitors (PIs), and about their experiences taking and adhering to regimens containing PIs.

DESIGN:

Six focus groups of persons under care for HIV were conducted between September and November 1996 regarding participants’ knowledge, awareness, experiences when taking, and adherence to antiretroviral regimens containing PIs. An identical discussion guide was used to facilitate all six groups. Focus group proceedings were audiotaped, transcribed, coded for themes, and analyzed qualitatively.

SETTING:

HIV/AIDS practices of three teaching hospitals and two community health centers.

PATIENTS/PARTICIPANTS:

Fifty-six patients with HIV disease: 28 men and 28 women.

MEASUREMENTS AND MAIN RESULTS:

Knowledge and positive impressions of PIs were prevalent among this diverse group of persons with HIV, and did not differ by race/ethnicity or gender. Most knew that these were new, potent medications for treating HIV/AIDS. Networks of persons with HIV and medical providers were the most important information sources. Those taking PIs were aware that adherence to the regimen is important, and most were using special strategies to maximize their own adherence, but expressed considerable frustration about the central role these medication regimens had assumed in their life. A subset who did not believe they would adhere to these regimens had declined treatment with them. Motivating factors for taking and adhering to these complex regimens were improving CD4 counts and viral loads and the patient-provider relationship.

CONCLUSIONS:

Among those with HIV/AIDS, awareness of PIs and their effectiveness is substantial, owing to the impact of informal networks and medical providers. This early positive “reputation” of PIs may enhance motivation for adherence. Those who are taking PIs invest substantial effort adhering to these complex regimens, but resent the need to make medications the focus of their lives.

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