Symptom Interpretation and Medication Adherence among Late Middle-age and Older HIV-infected Adults

All individuals, whether healthy or ill, have bodily 'expectancies'. Symptoms recognized as deviations from these expectancies necessitate interpretive activities. The behavioral implications of symptom interpretations are explored using data from a psychosocial study of the adaptation to HIV illness among late middle-aged and older men and women. Thematic analysis revealed that rather than the mere presence of symptoms, it was the attributions made for these symptoms that influenced whether patients adhered to multidrug antiviral medications. Decreased adherence was reported when symptoms were interpreted as side-effects because these symptoms were interpreted as evidence that the medications were making them sicker or had greater risks than benefits. Similarly, the failure of medications to relieve symptoms also negatively influenced adherence because they were interpreted as not having any effect. In nearly all cases, physicians were not consulted until after non-adherence, if at all. Implications of symptom interpretations for patient care and intervention are discussed.