Self-Reported Adherence to Antiretroviral Treatment and Degree of Sense of Coherence in a Group of HIV-Infected Patients

Abstract

The goal of this study was to explore the relation between self-reported adherence to anti-retroviral treatment and degree of sense of coherence in a group of human immunodeficiency virus (HIV)-infected patients. Ninety-nine patients from an outpatient clinic, all undergoing antiretroviral therapy, participated. Questionnaires were answered twice at a 12-month interval. The 29-item Sense of Coherence (SOC) Scale was used for measuring the ability to cope with stressful life situations. Medication adherence was assessed with self-reported measurements. Clinical characteristics and background variables were collected from the medical records. Results from variables measured with the 12-month interval show a significant concordance with disease stage (p ≤ 0.0001), and in HIV-RNA copies per milliliter(p ≤ 0.0001) and an increase in CD4 cell count/mm³ (p = <0.0001). Univariate analysis showed significant differences between nonadherent patients (n = 19) and adherent patients(n = 80) at the last measurement (i.e., the nonadherent group had lower CD4 cell count/mm³ [p = 0.004], higher HIV-1 RNA levels [p 5 0.029], and lower SOC [p = 0.04] than the adherent group). Finally, multiple regression analyses showed that at measurement 2 the SOC predicted nonadherence, the lower SOC the more missed doses (p ≤ 0.01). Because SOC seems to play an important role in this group of patients managing their disease, a caring patient–provider relationship should be developed to minimize nonadherent behaviour. For this reason SOC scale might be of great clinical value to identify patients needing the most support for successful treatment.