Lipodystrophy-associated symptoms and medication adherence in HIV/AIDS

Lipodystrophy-associated manifestations remain a challenge for persons infected with HIV disease and their care providers. Symptomatic HIV disease and side effects of medications are implicated in antiretroviral medication nonadherence. This study examined the relationship between time since initial diagnosis with HIV, presence and type of lipodystrophic symptoms, and adherence to medication regimens in persons with HIV/AIDS. Using a cross-sectional, descriptive design, the sample was composed of 165 persons from three outpatient HIV settings in Boston, Massachusetts; Fresno, California; and Victoria, Texas. Participants completed a questionnaire comprised of sociodemographic questions, adherence scales, quality-of-life scales, and open-ended questions regarding presence and types of lipodystrophy-associated symptoms, and how these physical changes made them feel. Adherence was moderate with a mean score of 1.44 (standard deviation [SD] +/- 1.33) on the Morisky Medication Adherence Scale (MMAS). The MMAS is a Likert-type scale ranging from 0-4, with "0" indicating very adherent. This finding indicated that the participants took their medications moderately well despite self-reports of significant numbers of HIV disease and treatment-related body fat changes. Time since initial diagnosis was 8.86 +/- 5.55 years and was not related to adherence. Nor did the type of lipodystrophic symptoms affect adherence. Quality of life however, was significantly related to adherence suggesting an approach that might be taken to improve adherence.