Biopsychosocial Barriers, Motivational Interviewing, and Antiretroviral Medication Adherence in Persons Living with HIV and AIDS

Since the development of antiretroviral medications in the mid-1990s, treatment of human immunodeficiency virus (HIV) infection has improved steadily and HIV is now considered a manageable chronic condition with improved quality of life for those who are medically adherent. However, medication regimens typically require near perfect adherence to be effective and people living with HIV/AIDS (PLWHA) may experience a unique set of biopsychosocial barriers that limit or inhibit their ability to be medically adherent. The purpose of this study was to examine the influence of biopsychosocial factors and motivational interviewing on antiretroviral medication adherence in people living with HIV/AIDS (PLWHA). Specifically, this study explored how biopsychosocial barriers (i.e., physical health, mental health, substance use, housing, transportation, and employment concerns) and motivational interviewing predict antiretroviral medication adherence in PLWHA as measured by patients' CD4 count and HIV viral load. This study utilized archival data that was collected between July 2013 and July 2016 at the Brody School of Medicine HIV Clinic and captured patients' biopsychosocial barriers, CD4 count and HIV viral load. A stratified sample of 210 patients was drawn from the archival data for this study. Multiple logistic regression analysis showed that patients' CD4 count cut scores at intake made a significant contribution to the prediction of medication adherence as measured by PLWHA CD4 count cut scores at week 21, when controlling for patients' CD4 count cut scores at intake. Comparatively, results showed a statistical significance for the barrier substance use when examining antiretroviral medication adherence in PLWHA as measured by patients' HIV viral load cut scores at week 21. Further, a non-significant association between patients' CD4 cut scores at week 21 and patients' HIV viral load cut scores at week 21 in predicting antiretroviral medication adherence was found. The results of this study suggest that patients' starting CD4 count and substance use are important components that warrant further research for PLWHA. Further, this study has implications for healthcare professionals, counselors, and counselor educators related to substance use concerns for this specific population. Future research exploring substance use treatment and ARV medication adherence in PLWHA is suggested