Student Abstracts

Self-Efficacy, Stage of Change and Medication Adherence in HIV Disease

Author: Ashley Reynolds, MSN, RN

Keywords: Self-Efficacy, Transtheoretical Model, Adherence, HIV, Stage of Change, Healthy Behaviors, Behavior Change, Spearman Rho Correlation, Chronic Disease Management

Objectives: HIV medication adherence is vital to the success of treatment. Non-adherence can result in poor outcomes including: drug resistance, shorter duration of regimen and decreased options to treat HIV disease. The purpose of this pilot study was:  a) to assess a patient’s perception of self-efficacy and stage of change using an assessment tool for those who have been prescribed an HIV medication regimen, and b) to discover relationships between the concepts of self-efficacy, stage of change, and medication adherence.

Methods: A convenience sample of HIV positive adults (N=32) was interviewed in a large, metropolitan HIV clinic setting.  Self-Efficacy for HIV specific tasks was assessed using a previously validated tool called the HIV-SE scale. Stage of change for medication adherence was measured using a two-part questionnaire (SOC). Adherence to HIV medication was assessed using self-reported adherence questions (MAS). Multilevel logistic models were used to study the impact of self-efficacy and stage of change on adherence, as well as the effect of medication characteristics (such as the average length of time on HIV medication therapy), length of HIV diagnosis, and patients' sociodemographic characteristics.

Results: The link between self-efficacy and medication adherence was significantly correlated (-0.63, P = 0.002).  The negative correlation represents that the higher a self-efficacy score, the lower the score for medication adherence. A lower MAS score means better adherence to medications.  Neither the variables of self-efficacy and stage of change (0.31, P = 0.20), nor stage of change and medication adherence (-0.25, P = 0.10) were significantly correlated in this sample. More data is needed with a larger sample size to determine significance of the results between the SE-SOC and SOC-MAS. The time a participant was HIV positive appears to be a significant predictor of Medication Adherence (P = 0.05).  In addition, a participant’s race appears to be a significant predictor of self-efficacy (P = 0.05).

Conclusions: Further analysis is needed to observe whether certain demographic variables such as race or sexual orientation can be effective predictors of medication adherence, a person’s stage of change or self-efficacy. In addition, certain variables were just above the (P = 0.05) level of significance and should be studied further with a larger sample to observe whether they truly are significant factors. The concept of self-efficacy appears to be the strongest variable observed in this study with several analytical methods demonstrating significance (P = 0.002).  The concept of the stage of change appeared to not be significantly related to the other two concepts and requires further study to ascertain if any relationships exist.

Author Contact Info:
Email: AshleyReynolds30@comcast.net
Phone: (904) 571-1797