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Mapping patient-identified barriers and facilitators to retention in HIV care and antiretroviral therapy adherence to Andersen's Behavioral Model.
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- Author(s): Holtzman, Carol W.1 (AUTHOR) ; Shea, Judy A.2 (AUTHOR); Glanz, Karen3,4 (AUTHOR); Jacobs, Lisa M.5 (AUTHOR); Gross, Robert2,3,6 (AUTHOR); Hines, Janet2 (AUTHOR); Mounzer, Karam2,7 (AUTHOR); Samuel, Rafik8 (AUTHOR); Metlay, Joshua P.9 (AUTHOR); Yehia, Baligh R.2 (AUTHOR)
- Source:
AIDS Care. Jul2015, Vol. 27 Issue 7, p817-828. 12p. 2 Diagrams, 5 Charts.- Subject Terms:
*ANTIVIRAL agents; *CONCEPTUAL structures; *GROUNDED theory; *HEALTH attitudes; *HEALTH services accessibility; *HIV-positive persons; *HOUSING; *HEALTH insurance; *INTERVIEWING; *LITERACY; *MATHEMATICAL models; *RESEARCH methodology; *MENTAL illness; *PATIENT compliance; *RESEARCH funding; *SOCIAL stigma; *SUBSTANCE abuse; *TRANSPORTATION; *THEORY; *SOCIAL support; *THEMATIC analysis; *PATIENTS' attitudes; *DESCRIPTIVE statistics; *CD4 lymphocyte count - Source:
- Additional Information
- Subject Terms:
- Abstract: Andersen's Behavioral Model (ABM) provides a framework for understanding how patient and environmental factors impact health behaviors and outcomes. We compared patient-identified barriers/facilitators to retention in care and antiretroviral therapy (ART) adherence and evaluated how they mapped to ABM. Qualitative semi-structured interviews with 51 HIV-infected adults at HIV clinics in Philadelphia, PA, in 2013 were used to explore patients' experiences with HIV care and treatment. Interview data were analyzed for themes using a grounded theory approach. Among those interviewed, 53% were male and 88% were nonwhite; 49% were retained in care, 96% were on ART, and 57% were virally suppressed. Patients discussed 18 barriers/facilitators to retention in care and ART adherence: 11 common to both behaviors (stigma, mental illness, substance abuse, social support, reminder strategies, housing, insurance, symptoms, competing life activities, colocation of services, provider factors), 3 distinct to retention (transportation, clinic experiences, appointment scheduling), and 4 distinct to adherence (medication characteristics, pharmacy services, health literacy, health beliefs). Identified barriers/facilitators mapped to all ABM domains. These data support the use of ABM as a framework for classifying factors influencing HIV-specific health behaviors and have the potential to inform the design of interventions to improve retention in care and ART adherence. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of AIDS Care is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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