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Psychological Reactance is a Novel Risk Factor for Adolescent Antiretroviral Treatment Failure
Elizabeth Lowenthal1,2,3, Mitchelle Matesva4, Tafireyi Marukutira5
1The Children's Hospital of Philadelphia Research Institute, Philadelphia, PA, USA. lowenthale@email.chop.edu.
Abstract:
Psychological reactance is an aversive response to perceived threats against personal agency. For adolescents receiving HIV treatment in Botswana, we utilized a two-question, medication-specific reactance tool to assess whether: (1) verbal reminders to take medicines made adolescents want to avoid taking them, and, (2) whether adolescents felt anger when reminded to take medicines. Reactant adolescents had 2.05-fold (95% CI 1.23, 3.41) greater odds of treatment failure than non-reactant adolescents (p = 0.03). Adjusted risk of treatment failure was 14% (95% CI 3%, 28%) greater for each point elevation in reactance score (p = 0.016). Autonomy over medication-taking did not modify the association between reactance and treatment failure. Psychological reactance may be a useful interventional target for improving adolescent adherence.
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