Safren S A, Otto M W, Worth J L, Salomon E, Johnson W, Mayer K, Boswell S
Massachusetts General Hospital and Harvard Medical School, Boston MA 02114, USA.
Behav Res Ther. 2001 Oct;39(10):1151-62. doi: 10.1016/s0005-7967(00)00091-7.
Advances in the medical treatment of HIV have made it clear that adherence to highly active antiretroviral treatment is a crucial feature for treatment success. The present paper had two goals: (1) to examine psychosocial predictors of adherence in persons receiving HIV antiretroviral therapy; (2) to compared two minimal-treatment interventions to increase HIV medication adherence in a subset of persons who self-reported less than perfect adherence. One of the interventions, Life-Steps, is a single-session intervention utilizing cognitive-behavioral, motivational interviewing, and problem-solving techniques. The other intervention, self-monitoring, utilizes a pill-diary and an adherence questionnaire alone. Significant correlates of adherence included depression, social support, adherence self-efficacy, and punishment beliefs about HIV. Depression was a significant unique predictor of adherence over and above the other variables. Both interventions yielded improvement in adherence from baseline, and the Life-Steps intervention showed faster improvements in adherence for persons with extant adherence problems.
艾滋病病毒（HIV）医学治疗方面的进展已明确表明，坚持高效抗逆转录病毒治疗是治疗成功的关键因素。本论文有两个目标：（1）研究接受HIV抗逆转录病毒治疗者坚持治疗的心理社会预测因素；（2）比较两种最小化治疗干预措施，以提高自我报告坚持治疗情况欠佳的一部分人的HIV药物治疗依从性。其中一种干预措施“生活步骤”是一种单节次干预，运用认知行为、动机访谈和解决问题的技巧。另一种干预措施“自我监测”仅使用服药日记和一份依从性调查问卷。依从性的显著相关因素包括抑郁、社会支持、依从性自我效能以及对HIV的惩罚信念。抑郁是在其他变量之外依从性的一个显著独特预测因素。两种干预措施均使依从性从基线水平有所改善，并且“生活步骤”干预措施对存在现有依从性问题的人而言，在依从性方面显示出更快的改善。
