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Predicting acceptance of highly active antiretroviral treatment (HAART): the role of patients' perceptions of illness and treatment.

Horne R, Cooper V, Gellaitry G, Lambert N, Fisher M; International Conference on AIDS.

Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. WePeB5862.

University of Brighton, Brighton, United Kingdom

BACKGROUND: This study aimed to improve our understanding of why approximately a third of patients decline HAART when it is clinically indicated. We hypothesised that the decision to accept or decline HAART would be predicted by patients' personal beliefs about HAART and HIV as specified in an extended self-regulatory theory. METHODS: A prospective, longitudinal study in which consecutive patients offered HAART (within BHIVA Guidelines) completed validated questionnaires assessing perceptions of HIV (symptoms, timeline, personal consequences, amenability to control and emotional impact) and beliefs about HAART (perceptions of personal need for HAART and concerns about potential adverse effects). The effect of baseline beliefs on the subsequent decision to accept or decline HAART was examined. RESULTS: Sixty-two (73%) patients accepted HAART and twenty-three (27%) declined. There was considerable variation in personal beliefs about HIV and HAART. These beliefs influenced uptake. Choosing to decline HAART was associated with doubts about personal need for HAART (t=-3.30; P<0.001) and to a range of concerns about potential adverse effects (t=2.72; p<0.005). People who accepted HAART had a greater belief in the ability of HAART to control their condition (treatment control t=4.25, P<0.0001) and were more likely to believe that their condition would improve in time (timeline t = -3.37; p < 0.005). CONCLUSIONS: Patients' beliefs about HAART and HIV often differed from the 'medical view' yet strongly influenced the decision about whether to accept or decline HAART, when clinically indicated. The findings of this study will be used as the basis for an intervention study to assess the effects of 'decision support' on uptake of HAART. We are extending the study to assess the effects of these beliefs on subsequent adherence.

Publication Types:
  • Meeting Abstracts
Keywords:
  • Acquired Immunodeficiency Syndrome
  • Antiretroviral Therapy, Highly Active
  • HIV Infections
  • HIV Seropositivity
  • Humans
  • Perception
  • Prospective Studies
  • Questionnaires
  • drug therapy
  • therapy
Other ID:
  • GWAIDS0017497
UI: 102254995

From Meeting Abstracts




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