Intentional and unintentional nonadherence in patients prescribed HAART treatment regimens

The objective was to investigate intentional and unintentional nonadherence to anti-HIV treatment regimens from a decision-making perspective. The participants (n = 117) being treated with anti-HIV medication completed a questionnaire asking about nonadherence; reasons for and against taking the medication; and medical consultation style. Thirty-three participants (29%) reported intentionally missing or altering doses of medication at least 5% of the time; 59 participants (50%) reported forgetting to take medication at least 5% of the time. Intentional nonadherence was associated with the balance of the perceived benefits and losses of taking medication, and extent to which participants were 'prepared for the effects of the medication'. Unintentional nonadherence was associated with demographic and clinical variables. The research highlights the importance of (i) treating intentional and unintentional nonadherence as separate entities; (ii) assessing individuals' idiosyncratic beliefs and internal logic when considering intentional nonadherence; and (iii) ensuring that individuals feel prepared for the effects of their medications.