Atkinson J S, Schönnesson L Nilsson, Williams M L, Timpson S C
School of Public Health, University of Texas Health Science Center at Houston, 7000 Fannin Street, Houston, TX 77030, USA.
AIDS Care. 2008 Feb;20(2):253-62. doi: 10.1080/09540120701506788.
Adherence to HIV medication regimens is a function of multiple dimensions including psychological functioning, social support, adherence self-efficacy and optimism regarding treatment. Active substance use can also negatively affect adherence. An understanding of the nature of the associations among the correlates of adherence can better inform the design of interventions to improve adherence. This study developed an exploratory path model of schedule adherence using data from a sample 130 African-American HIV-positive crack cocaine users on highly active antiretroviral therapy (ART). This model was based on the Transactional Model of Stress and Coping developed by Lazarus and Folkman. Following the theory, the effects of psychological distress on schedule adherence were mediated by patients' relationship with their doctor and optimism towards antiretroviral treatment. Adherence was also associated with patients' self-efficacy regarding their medical regimen which, in turn, was associated with their social support.
坚持服用抗逆转录病毒药物治疗方案受多个维度的影响，包括心理功能、社会支持、坚持服药的自我效能感以及对治疗的乐观态度。活跃的物质使用也会对服药依从性产生负面影响。了解服药依从性相关因素之间关联的本质，可为改善依从性的干预措施设计提供更好的指导。本研究利用130名接受高效抗逆转录病毒治疗（ART）的非裔美国艾滋病毒阳性可卡因吸食者样本的数据，建立了一个服药依从性的探索性路径模型。该模型基于拉扎勒斯和福克曼提出的应激与应对的交易模型。根据该理论，心理困扰对服药依从性的影响是通过患者与医生的关系以及对抗逆转录病毒治疗的乐观态度来介导的。服药依从性还与患者对其医疗方案的自我效能感相关，而自我效能感又与他们的社会支持相关。
