The goal in this article is to examine social problems associated with highly active antiretroviral therapy (HAART) adherence in Mexico and the related challenges for Mexican persons living with HIV/AIDS (PLWHAs). The study was conducted from the perspective of infected and affected individuals. The authors completed 64 in-depth interviews with heterosexual male and female PLWHAs, as well as with some key individuals from their social network. Following the principles of grounded theory, they carried out inductive analysis to create codes and organize central themes. The authors identified problems related to accessing HAART and found that conditions for implementing recommendations made in the international literature to improve adherence are poor. The findings highlight the importance of social factors, such as health care system irregularities, ineffective physician—patient communication, and availability of family and other sources of social support such as self-help groups for PLWHAs' access and adherence to antiretroviral therapy in Mexico.
Agencia de noticias: Notiese Laneta Org. ( 2004). Agencia_notiese: Notiese salud sexualidad y Sida [Health, sexuality, and AIDS]. Retrieved March 23, 2006, from http://www.laneta.apc.org/mailman/listinfo/agencia_notiese
2.
Altice, F.L., & Frederick, L. (1998). The era of adherence to HIV therapy. Annals of Internal Medicine, 129(6), 503-505.
3.
Anderson, E., & Hull Spencer, M. (2002). Cognitive representations of AIDS: A phenomenological study. Qualitative Health Research , 12(10), 1338-1352.
4.
Andrews, L., & Friedland, G. (2000). Progress in HIV therapeutics and the challenges of adherence to antiretroviral therapy. Infectious Disease Clinics of NorthAmerica, 14(4), 901-928.
5.
Bertaux, D. (1993). Los relatos de vida en el análisis social [Life narratives in social analysis]. In J. A. Lozano (Ed.), Historia oral (pp. 136-148). México City , México: Instituto Mora.
6.
Bowling, A. (2002). Research methods in health: Investigating health and health services (2nd ed.). Philadelphia: Open University Press.
7.
Burgoyne, R.W. (2005). Exploring direction of causation between social support and clinical outcome for HIV-positive adults in the context of highly active antiretroviral therapy. AIDS Care, 17(1), 111-124.
8.
Censida. (2006). El Sida en cifras 2006 & Guía de manejo antiretroviral de las personas que viven con el VIH/SIDA [AIDS in figures 2006 & Guide for the clinical management of PLHA's antiretroviral treatment]. Retrieved December 15, 2006 , from http://www.ssa.gob.mx/conasida
9.
Delgado, J.,Heath, K.V., Yip, B., Marion, S., Alfonso, V., Montaner, J.S., et al. (2003). Highly active antiretroviral therapy: Physician experience and enhanced adherence to prescription refill. AntiviralTherapy, 8(5), 471-478.
10.
Edwards, L.V. (2006). Perceived social support and HIV/AIDS medication adherence among African American women. Qualitative Health Research, 16, 679-691.
11.
Glaser, B.G., & Strauss, A.L. (1967). The discovery of grounded theory. Strategies for qualitative research. New York: Aldine.
12.
Gordillo, V., del Amo, J., Soriano, V., & Gonzalez-Lahoz, J. (1999). Sociodemographic and psychologic variables influencing adherence to antiretroviral therapy. AIDS, 13(13), 1763-1769.
13.
Heckman, B.D., Catz, S.L., Heckman, T.G., Miller, J.G., & Kalichman, S.C. (2004). Adherence to antiretroviral therapy in rural persons living with HIV disease in the United States. AIDS Care, 16(2), 219-230.
14.
Ickovics, J.R., & Meade, C.S. (2002). Adherence to antiretroviral therapy among patients with HIV: A critical link between behavioral and biomedical sciences. Journal of Acquired Immune Deficiency Syndromes, 15(31, Suppl. 3), S98-S102.
15.
Kumarasamy, N., Safren, S.A., Raminani, S.R., Pickard, R., James, R., Krishnan, A.K., et al. (2005). Barriers and facilitators to antiretroviral medication adherence among patients with HIV in Chennai, India: A qualitative study. AIDS Patient Care STDS, 19(8), 526-537.
16.
Magis-Rodríguez, C., Esquivel-Pedraza, L., & López-Martínez, C. (1999). Experiencia en el manejo del paciente con VIH entre médicos de la Secretaría de Salud [Experiences in the clinical management of HIV patients among Ministry of Health physicians] . Salud Pública de México, 41(1), 460-465.
17.
Mannheimer, S.B., Matts, J., Telezak, E., Chesney, M., Child, C., & Friedland, W.W. (2005). Quality of life in HIV-infected individuals receiving antiretroviral therapy is related to adherence. AIDS Care, 17(1), 10-22.
18.
McCoy, L. (2005). HIV-positive patients and the doctor-patient relationship: Perspectives from the margins. Qualitative Health Research , 15, 791-806.
19.
Murphy, D.A., Marelich, W.D., Hoffman, D., & Steers, W.N. (2004). Predictors of antiretroviral adherence. AIDS Care, 16(4), 471-484.
20.
Murphy, D.A., Roberts, K.J., Hoffman, D., Molina, A., & Lu, M.C. (2003). Barriers and successful strategies to antiretroviral adherence among HIV-infected monolingual Spanish-speaking patients. AIDS Care, 15(2), 217-230.
21.
Murri, R., Antinori, A., Ammassari, A., Nappa, S., Orofino, G., Abrescia, N., et al. (2002). Physician estimates of adherence and the patient-physician relationship as a setting to improve adherence to antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes, 15, 158-162.
22.
National Institute of Public Health. (2003 ). Impact of heterosexual gender roles on quality of life and access to social support for HIV-positive Mexican men and women, developed in: A research project. Unpublished manuscript, Cuernavaca , México.
23.
Paterson, D.L., Swindells, S., Mohr, J., Brester, M., Vergis, E.N., Squier, C., et al. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine, 133(1), 21-30.
24.
Roberts, K.J. (2000a). Barriers to and facilitators of HIV-positive patients' adherence to antiretroviral treatment regimens. AIDS Patient Care and Sexually Transmitted Diseases, 14(3), 155-168.
25.
Roberts, K.J. (2000b). Physician beliefs about antiretroviral adherence communication. AIDS Patient Care and Sexually Transmitted Diseases, 14(9), 477-484.
26.
Roberts, K.J. (2002). Physician-patient relationships, patient satisfaction, and antiretroviral medication: Adherence among HIV-infected adults attending a public health clinic. AIDS Patient Care Sexually Transmitted Diseases, 16(1), 43-50.
27.
Roberts, K.J., & Mann, T. (2000). Barriers to antiretroviral medication adherence in HIV-infected women. AIDS Care, 12(9), 377-386.
28.
Segurado, A.S., Miranda, S., Oliveira, M.R., & The Brazilian Enhancing Care Initiative Team. (2003). Evaluation of the care of women living with HIV/AIDS in São Paulo, Brazil. AIDS Patient Care and STDs, 17(2), 85-93.
29.
Strauss, A., & Corbin, J. (2003). Bases de la investigación cualitativa técnicas y procedimientos para desarrollar la teoría fundamentada [Basics of qualitative research: Grounded theory procedures and techniques]. Medellín, Colombia: Ediciones y Universidad de Antioquia.
30.
Tuldra, A., & Wu, A.W. (2002). Interventions to improve adherence to antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes, 15, S154-S157.
31.
Van Servellen, G., & Lombardi, E. (2005). Supportive relationships and medication adherence in HIV-infected, low-income Latinos. Western Journal of Nursing Research, 27(8), 1023-1039.
32.
Wainberg, M.A., & Friedland, G.H. (1998). Public health implications of antiretroviral therapy and HIV drug resistance. Journal of the American Medical Association, 279(24), 1977-1983.
33.
Warren, C.A.B. (2002). Qualitative interviewing. In J. F. Gubrium & J. A. Holstein (Eds.), Handbook of interviewing research: Context and method (pp. 83-102). London: Sage.
34.
Wilson, H.S., Hutchinson, S.A., & Holzemer, W. (2002). Reconciling incompatibilities: A grounded theory of HIV medication adherence and symptom management. Qualitative Health Research, 12, 1309-1322.
35.
Word, S.A., Tobias, C., & McCree, J. (2004). Medication adherence for HIV positive women caring for children: In their own words. AIDS Care, 16(7), 909-913.
