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UBC Theses and Dissertations

Predictors of antiretroviral adherence self-efficacy among people living with HIV/AIDS who use illicit drugs Lee, William


Although the benefits of antiretroviral therapy (ART) on the quality of life of people living with HIV/AIDS (PLWHA) who use illicit drugs have been well-described, sub-optimal adherence to ART remains an ongoing health concern. Positive health outcomes associated with adherence self-efficacy have been well-documented but there is a paucity of research exploring the antecedents of this construct. This study sought to identify possible determinants of adherence self-efficacy among a cohort of PLWHA who use illicit drugs. From December 2005 to June 2014, data were collected from the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS), a prospective cohort of adult PLWHA who use illicit drugs in Vancouver, Canada. We used multivariate linear regression to identify factors independently associated with higher ART adherence self-efficacy. Among 520 participants, older age and Caucasian ethnicity significantly and independently predicted higher levels of ART adherence efficacy expectations and self-regulatory efficacy, being employed predicted only higher levels of ART adherence efficacy expectations, whereas daily cocaine injection and being homeless significantly and independently predicted lower levels of ART adherence self-regulatory efficacy. Although this study highlights the potential importance that some demographic and contextual factors play in shaping adherence self-efficacy within the context of HIV and illicit drug use, efforts should be made to address methodological inconsistencies when investigating self-efficacy across different populations, including PLWHA. Future findings in this area introduce the notion of implementing screening measures for those at-risk for low ART adherence self-efficacy, as well as tailoring psychotherapy among PLWHA to increase aspects of adherence self-efficacy.

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