Psychological factors, beliefs about medication, and adherence of youth with human immunodeficiency virus in a multisite directly observed therapy pilot study

Patricia A. Garvie, Patricia M. Flynn, Marvin Belzer, Paula Britto, Chengcheng Hu, Bobbie Graham, Michael Neely, George D. McSherry, Stephen A. Spector, Aditya H. Gaur

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

This study examined psychological functioning and beliefs about medicine in adolescents with human immunodeficiency virus (HIV) on highly active antiretroviral therapy in a community-based directly observed therapy (DOT) pilot feasibility study. Participants were youth with behaviorally acquired HIV (n = 20; 65% female; median age, 21 years) with adherence problems, who received once-daily DOT. Youth were assessed at baseline, week 12 (post-DOT), and week 24 (follow-up). At baseline, 55% of youth reported having clinical depressive symptoms compared to 27% at week 12 with sustained improvements at week 24. At baseline, substance use was reported within the borderline clinical range (Tscore = 68), with clinical but statistically nonsignificant improvement (Tscore = 61) at week 12. Hopelessness scores reflected optimism for the future. Coping strategies showed significantly decreased cognitive avoidance (p = .02), emotional discharge (p = .004), and acceptance/resignation ("nothing I can do," p = .004), whereas positive reappraisal and seeking support emerged. With the exception of depressive symptoms, week 12 improvements were not sustained at week 24. DOT adherence was predicted by higher baseline depression (p = .05), beliefs about medicine (p = .006) and perceived threat of illness scores (p = .03). Youth with behaviorally acquired HIV and adherence problems who participated in a community-based DOT intervention reported clinically improved depressive symptoms, and temporarily reduced substance use and negative coping strategies. Depressive symptoms, beliefs about medicine, and viewing HIV as a potential threat predicted better DOT adherence.

Original languageEnglish (US)
Pages (from-to)637-640
Number of pages4
JournalJournal of Adolescent Health
Volume48
Issue number6
DOIs
StatePublished - Jun 2011

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Directly Observed Therapy
Medication Adherence
HIV
Psychology
Depression
Medicine
Adolescent Medicine
Highly Active Antiretroviral Therapy
Feasibility Studies

Keywords

  • Adherence
  • Adolescent
  • Directly observed therapy (DOT)
  • HIV
  • Psychological functioning

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health

Cite this

Psychological factors, beliefs about medication, and adherence of youth with human immunodeficiency virus in a multisite directly observed therapy pilot study. / Garvie, Patricia A.; Flynn, Patricia M.; Belzer, Marvin; Britto, Paula; Hu, Chengcheng; Graham, Bobbie; Neely, Michael; McSherry, George D.; Spector, Stephen A.; Gaur, Aditya H.

In: Journal of Adolescent Health, Vol. 48, No. 6, 06.2011, p. 637-640.

Research output: Contribution to journalArticle

Garvie, Patricia A. ; Flynn, Patricia M. ; Belzer, Marvin ; Britto, Paula ; Hu, Chengcheng ; Graham, Bobbie ; Neely, Michael ; McSherry, George D. ; Spector, Stephen A. ; Gaur, Aditya H. / Psychological factors, beliefs about medication, and adherence of youth with human immunodeficiency virus in a multisite directly observed therapy pilot study. In: Journal of Adolescent Health. 2011 ; Vol. 48, No. 6. pp. 637-640.
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