Medication-Taking Practices of Patients on Antiretroviral HIV Therapy: Control, Power, and Intentionality

Kathryn E. Muessig, Abigail T. Panter, Mary S. Mouw, Kemi Amola, Kathryn E. Stein, Joseph S. Murphy, Eric M. Maiese, David A. Wohl

Research output: Contribution to journalArticle

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Abstract

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) is crucial for health, but patients face numerous challenges achieving sustained lifetime adherence. We conducted six focus groups with 56 PLWH regarding ART adherence barriers and collected sociodemographics and ART histories. Participants were recruited through clinics and AIDS service organizations in North Carolina. Dedoose software was used to support thematic analysis. Participants were 59% male, 77% black, aged 23-67 years, and living with HIV 4-20 years. Discussions reflected the fluid, complex nature of ART adherence. Maintaining adherence required participants to indefinitely assert consistent control across multiple areas including: their HIV disease, their own bodies, health care providers, and social systems (e.g., criminal justice, hospitals, drug assistance programs). Participants described limited control over treatment options, ART's impact on their body, and inconsistent access to ART and subsequent inability to take ART as prescribed. When participants felt they had more decision-making power, intentionally choosing whether and how to take ART was not exclusively a decision about best treating HIV. Instead, through these decisions, participants tried to regain some amount of power and control in their lives. Supportive provider relationships assuaged these struggles, while perceived side-effects and multiple co-morbidities further complicated adherence. Adherence interventions need to better convey adherence as a continuous, changing process, not a fixed state. A perspective shift among care providers could also help address negative consequences of the perceived power struggles and pressures that may drive patients to exert control via intentional medication taking practices.

LanguageEnglish (US)
Pages606-616
Number of pages11
JournalAIDS Patient Care and STDs
Volume29
Issue number11
DOIs
StatePublished - Jan 1 2015

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HIV
Therapeutics
Criminal Law
Power (Psychology)
Focus Groups
Health Personnel
Decision Making
Acquired Immunodeficiency Syndrome
Software
Organizations
Morbidity
Pressure
Health
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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Medication-Taking Practices of Patients on Antiretroviral HIV Therapy : Control, Power, and Intentionality. / Muessig, Kathryn E.; Panter, Abigail T.; Mouw, Mary S.; Amola, Kemi; Stein, Kathryn E.; Murphy, Joseph S.; Maiese, Eric M.; Wohl, David A.

In: AIDS Patient Care and STDs, Vol. 29, No. 11, 01.01.2015, p. 606-616.

Research output: Contribution to journalArticle

Muessig, Kathryn E. ; Panter, Abigail T. ; Mouw, Mary S. ; Amola, Kemi ; Stein, Kathryn E. ; Murphy, Joseph S. ; Maiese, Eric M. ; Wohl, David A./ Medication-Taking Practices of Patients on Antiretroviral HIV Therapy : Control, Power, and Intentionality. In: AIDS Patient Care and STDs. 2015 ; Vol. 29, No. 11. pp. 606-616
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