Insights into medication adherence among HIV-positive patients: the integrated change model

HIV/AIDS continues to pose a significant global public health challenge, with millions affected worldwide. Despite advancements in antiretroviral therapy (ART), achieving optimal adherence remains critical for improving health outcomes and preventing transmission. This study aims to identify the key determinants influencing medication adherence among HIV-positive patients in western Iran, utilizing the integrated change model as a theoretical framework to inform effective intervention strategies.

This descriptive-analytical cross-sectional study involved 262 HIV-positive individuals from the Behavioral Diseases Counseling Centers (BDCCs) of Kermanshah University of Medical Sciences in 2021. Data were collected through structured interviews using a questionnaire based on the I-Change Model, with 255 completed responses analyzed using SPSS-16.

The mean age of respondents was 39.04 years, with a majority being male (70.2%). The average medication adherence score was 21.09 [95% CI: 20.68, 21.50], indicating 84.36% adherence. In the adjusted regression model, significant determinants of medication adherence were job status (β = 0.133, P < 0.001) and behavioral skills (β = 0.296, P < 0.001), indicating their positive impact on adherence behavior. Conversely, perceived barriers (β = -0.418, P < 0.001) remained a strong negative correlate, highlighting the detrimental effect of barriers on adherence.

This study underscores the critical role of job status, behavioral skills, and perceived barriers in medication adherence. Clinically, healthcare providers must prioritize strategies to mitigate barriers and increasing behavioral skills. From a policy standpoint, expanding employment opportunities for individuals with HIV can support adherence and improve health outcomes.