Psychological model of ART adherence behaviors in persons living with HIV/AIDS in Mexico: a structural equation analysis

Abstract

OBJECTIVE: The objective of this study has been to test the ability of variables of a psychologicalmodel to predict antiretroviral therapy medication adherence behavior.METHODS: We have conducted a cross-sectional study among 172 persons living with HIV/AIDS(PLWHA), who completed four self-administered assessments: 1) the Psychological Variablesand Adherence Behaviors Questionnaire, 2) the Stress-Related Situation Scale to assess thevariable of Personality, 3) The Zung Depression Scale, and 4) the Duke-UNC Functional SocialSupport Questionnaire. Structural equation modeling was used to construct a model to predictmedication adherence behaviors.RESULTS: Out of all the participants, 141 (82%) have been considered 100% adherent toantiretroviral therapy. Structural equation modeling has confirmed the direct effect thatpersonality (decision-making and tolerance of frustration) has on motives to behave, or actaccordingly, which was in turn directly related to medication adherence behaviors. In addition,these behaviors have had a direct and significant effect on viral load, as well as an indirect effecton CD4 cell count. The final model demonstrates the congruence between theory and data(x2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fitindex = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance.CONCLUSIONS: Th e results of this study s upport o ur theoretical model a s a conceptualframework for the prediction of medication adherence behaviors in persons living with HIV/AIDS.Implications for designing, implementing, and evaluating intervention programs based on themodel are to be discussed