Adherence of human immunodeficiency virus-infected patients to antiretroviral therapy

The impact of demographic, psychosocial, and medical regimen-related variables on adherence of 123 human immunodeficiency virus (HIV)-infected patients to antiretroviral therapy was assessed by means of refill methodology. Satisfaction with social support (P =.029), problem-focused coping (P =.027), and active-behavioral coping (P =.011) correlated significantly with adherence, whereas loss of motivation (P =.006), hopelessness (P =.16), and avoidant coping (p =.015) correlated with nonadherence. At the 6-month follow-up, the mean CD4 cell count differed significantly among adherent versus nonadherent patients (a mean increase of 78/mm(3) vs. a mean decrease of 5/mm(3); P =.018). Adherence did not correlate with the number of antiretroviral medications consumed per day (mean, 3.0 vs. 2.5). Non-Caucasian patients were more likely to be nonadherent than Caucasian patients (relative risk, 2.5; 95% confidence interval, 1.2-5.3; P =.013); this difference was not explained by age, education, employment, income, history of intravenous drug use, or medical regimen. Non-Caucasian patients, however, were less satisfied with their social support (P =.04) and informational support (P =.016) and were more likely to utilize emotion-focused coping (P =.01). Thus, satisfaction with social support and coping style significantly impacted adherence and likely accounted for the observed racial difference in adherence among HIV-infected patients.