Benefits of Adherence to Psychotropic Medications on Depressive Symptoms and Antiretroviral Medication Adherence Among M
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ORIGINAL ARTICLE
Benefits of Adherence to Psychotropic Medications on Depressive Symptoms and Antiretroviral Medication Adherence Among Men and Women Living with HIV/AIDS Dean G. Cruess, Ph.D & Seth C. Kalichman, Ph.D & Christine Amaral, B.A & Connie Swetzes, L.P.N & Chauncey Cherry, M.P.H & Moira O. Kalichman, M.S.W
Published online: 11 November 2011 # The Society of Behavioral Medicine 2011
Abstract Background Psychotropic medications are commonly used for depressive symptoms among people living with HIV/AIDS. Purpose We examined the relationships between adherence to psychotropic medications, depressive symptoms, and antiretroviral adherence. Methods We assessed depressive symptoms among 324 people living with HIV/AIDS across a 3-month period (70% men; mean age 45 years; 90% African–American). Psychotropic and antiretroviral adherence was assessed using monthly, unannounced telephone pill counts. Multiple-regression and mediation analyses were utilized to examine associations under investigation. Results Greater depressive symptoms were associated with lower antiretroviral and psychotropic medication adherence. Greater adherence to psychotropic medications regardless of medication class was positively related to higher antiretroviral adherence. Greater adherence to psychotropic medications also significantly mediated the association between depressive symptoms and antiretroviral adherence. Conclusions This study demonstrates the benefits of adherence to psychotropic medications on both depressive D. G. Cruess : S. C. Kalichman : C. Amaral : C. Swetzes : C. Cherry : M. O. Kalichman Department of Psychology, University of Connecticut, Storrs, CT, USA D. G. Cruess Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA D. G. Cruess (*) 406 Babbidge Road, Unit 1020, Storrs, CT 06269-1020, USA e-mail: [email protected]
symptoms and antiretroviral adherence. Future work examining psychotropic medication adherence on disease outcomes in people living with HIV/AIDS is warranted. Keywords Medication adherence . Depression . HIV
Introduction Antiretroviral therapy is an effective strategy to reduce viral burden and improve morbidity and mortality among people living with HIV/AIDS [1–6]. These medications have revolutionized the treatment of HIV disease such that it is now viewed as a chronic condition. Antiretroviral medication adherence is vital for optimal outcomes. Resistance and other clinical complications may result if patients are not close to 95% adherence with their antiretroviral medications [7]. Patterns of adherence, duration of suppression, and other characteristics of HIV treatment adherence ultimately influence clinical outcomes [8, 9].Understanding the factors that influence antiretroviral adherence is a key aspect in managing HIV disease. Multiple factors influence medication adherence rates among people living with HIV/AIDS. Depression is one of the strongest independent psychosocial predictors of antiretroviral adherence [10–13]. Sub-clinical depressive symptoms can a
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