Stressful life events and adherence in HIV

Because medication adherence is critical to improving the virologic and immunologic response to therapy and reducing the risk of drug resistance, it is important that we understand the predictors of nonadherence. The goal of the current study is to examine demographic, health behavior and psychosocial correlates (e.g., stressful life events, depressive symptoms) of nonadherence among a sample of HIV infected men and women from one south Florida metropolitan area. We collected questionnaire data from on 105 HIV infected men and women who were taking antiretroviral medication during the years 2004 to 2007. In this sample, 44.8% had missed a medication dose in the past 2 weeks, and 22.1% had missed their medication during the previous weekend. Those with three or more stressful life events in the previous 6 months were 2.5 to more than 3 times as likely to be nonadherent (in the past 2 weeks and previous weekend, respectively) compared to those without such events. Fully 86.7% of those with six or more stresses were nonadherent during the prior 2 weeks compared to 22.2% of those with no stressors. Although alcohol consumption, drug use, and symptoms of depression were related to nonadherence in the bivariate analyses, the effects of these predictors were reduced to nonsignificance by the stressful event measure. These findings underscore the importance of addressing the often chaotic and stressful lives of HIV infected persons within medical settings.