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HIV-seropositive individuals’ optimistic beliefs about prognosis and relation to medication and safe sex adherence

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Abstract

OBJECTIVE: The study objective was to characterize respondents’ prognostic perceptions of HIV infection and to explore how perceptions might affect medication and safe sex nonadherence.

METHODS: Surveys were mailed to 295 clients of an HIV-specific case management organization. Participants were asked to describe experience with HIV/AIDS right after serostatus knowledge and currently, using provided word lists, after which they were asked to assess current life expectancy. Self-reported information on antiretroviral medication and safe sex nonadherence was obtained.

RESULTS: A total of 220 (75%) clients (66% nonwhite, 73% male, 63% gay/bisexual, 50% educated >12 years, and 53% with incomes <$10,000/year) returned surveys. Negative descriptors from word lists were significantly less common and positive descriptors significantly more common now compared to right after serostatus knowledge. Current perceptions about life expectancy indicated that most respondents thought they would live many years, many believing they would live well into old age. Whites (odds ratio [OR], 0.34; P=.01) were less likely and those with >12 years education (OR, 2.76; P=.02) and with CD4 cell counts >200 (OR, 2.70; P=.01) were more likely to have optimistic prognostic beliefs. The optimistic subgroup, when compared with the pessimistic subgroup, was more likely to report medication (26% vs 13%, P=.04) and safe sex (57% vs 29%, P=.004) nonadherence.

CONCLUSIONS: Seropositive individuals, including persons of color (adjusted) as well as women and drug users (unadjusted), self-reported optimistic beliefs about their prognosis. Those with more optimism about their prognosis were significantly more likely to report medication and safe sex nonadherence. A better understanding of seropositive patients’ prognostic beliefs and the factors determining them is warranted.

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References

  1. Sullivan A. When plagues end. The New York Times Magazine. November 10, 1996. 52–8, 60–2, 76–7, 84.

  2. James JS. New optimism on controlling HIV infection. ATN. 1996;249:1–3.

    Article  Google Scholar 

  3. Marwick C. HIV/AIDS care calls for reallocation of resources. JAMA. 1998;279:491–3.

    Article  PubMed  CAS  Google Scholar 

  4. Gallo RC. AIDS as a clinically curable disease: the growing optimism. Aids Patient Care STDS. 1996;10:7–9.

    Article  PubMed  CAS  Google Scholar 

  5. Altice FL, Friedland GH. The eral of adherence to HIV therapy. Ann Intern Med. 1998;129:503–5.

    PubMed  CAS  Google Scholar 

  6. Siegel K, Krauss BJ. Living with HIV infection: adaptive tasks of seropositive gay men. J Health Soc Behav. 1991;32:17–32.

    Article  PubMed  CAS  Google Scholar 

  7. Lerner BH, Gulick RM, Dubler NN. Rethinking nonadherence: historical perspectives on triple-drug therapy for HIV disease. Ann Intern Med. 1998;129:573–8.

    PubMed  CAS  Google Scholar 

  8. Montaner JSG, Reiss P, Cooper D, et al. A randomized, double-blind trial comparing combinations of nevirapine, didanosine, and zidovudine for HIV-infected patients: the INCAS Trial. JAMA. 1998;279:930–7.

    Article  PubMed  CAS  Google Scholar 

  9. Havlir DV, Marschner IC, Hirsch MS, et al. Maintenance antiretroviral therapies in HIV-infected subjects with undetectable plasma HIV RNA after triple-drug therapy. New Engl J Med. 1998;339:1261–8.

    Article  PubMed  CAS  Google Scholar 

  10. Ventura SJ, Peters KD, Martin JA, Maurer JD. Births and deaths: United States, 1996. Monthly Vital Statistics Report. Hyattsville, MD: National Center for Health Statistics; 1997.

    Google Scholar 

  11. Gulick RM, Mellors JW, Havlir D, et al. Treatment with indinivir, zidovudine, and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy. New Engl J Med. 1997;337:734–9.

    Article  PubMed  CAS  Google Scholar 

  12. Detels R, Muoz A, McFarlane G, et al. Effectiveness of potent antiretroviral therapy on time to AIDS and death in men with known HIV infection duration. JAMA. 1998;280:1497–503.

    Article  PubMed  CAS  Google Scholar 

  13. Stone VE, Mauch MY, Steger K, Janas SF, Craven DE. Race, gender, drug use, and participation in AIDS clinical trials. J Gen Intern Med. 1997;12:150–7.

    PubMed  CAS  Google Scholar 

  14. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Supplemental Report. Atlanta, Ga: U.S. Department of Health and Human Services, Centers for Disease Control; 2001; 1–16.

    Google Scholar 

  15. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report. Atlanta, Ga: U.S. Department of Health and Human Services, Centers for Disease Control; 2000:1–41.

    Google Scholar 

  16. Centers for Disease Control and Prevention. Update: Trends in AIDS incidence-United States, 1996. Morb Mortal Wkly Rep. 1997;46:861–7.

    Google Scholar 

  17. Centers for Disease Control. Summary of notifiable diseases, United States, 1998. Morb Mortal Wkly Rep. 1998;47:1–93.

    Google Scholar 

  18. Centers for Disease Control. Public Health Service guidelines for counseling and antibody testing to prevent HIV infection and AIDS. Morb Mortal Wkly Rep. 1987;36:509–15.

    Google Scholar 

  19. Centers for Disease Control. 1993 Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. Morb Mortal Wkly Rep. 1992;41:1–13.

    Google Scholar 

  20. Cunningham WE, Rana HM, Shapiro MF, Hays RD. Reliability and validity of self-report CD4 counts in persons hospitalized with HIV disease. J Clin Epidemiol. 1997;50:829–35.

    Article  PubMed  CAS  Google Scholar 

  21. Thompson C, Salvato PD. Intravenous Drug Use and the Immune System. Presented at the 12th International Conference on AIDS, Geneva, Switzerland, June 28–July 3, 1998. Faribault, Minn: Marathon Multimedia; 1998.

    Google Scholar 

  22. Deeks SG, Smith M, Holodniy M, Kahn JO. HIV-1 protease inhibitors: a review for clinicians. JAMA. 1997;277:145–53.

    Article  PubMed  CAS  Google Scholar 

  23. Rando TA. Death and the Dying Patient. Grief, Dying, and Death: Clinical Interventions for Caregivers. Champaign, Ill: Research Press Company; 1984:199–225.

    Google Scholar 

  24. Shapiro MF, Morton SC, McCaffrey DF, et al. Variations in the care of HIV-infected adults in the United States: results from the HIV Cost and Services Utilization Study. JAMA. 1999;281:2305–15.

    Article  PubMed  CAS  Google Scholar 

  25. Cunningham WE, Andersen RM, Katz MH, et al. The impact of competing subsistence needs and barriers on access to medical care for persons with HIV receiving care in the United States. Med Care. 1999;37:1270–81.

    Article  PubMed  CAS  Google Scholar 

  26. City of Philadelphia Department of Public Health. AIDS Surveillance Quarterly Update. (Cases Reported Through June 30, 1999). Philadelphia, PA: AIDS Activities Coordinating Office, Epidemiology Unit; 1999;19.

    Google Scholar 

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Correspondence to William C. Holmes MD, MSCE.

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This study was funded by the Research Foundation of the University of Pennsylvania. Dr. Holmes is supported by a grant from the National Institute of Allergy and Infectious Diseases (A10 1482).

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Holmes, W.C., Pace, J.L. HIV-seropositive individuals’ optimistic beliefs about prognosis and relation to medication and safe sex adherence. J GEN INTERN MED 17, 677–683 (2002). https://doi.org/10.1046/j.1525-1497.2002.00746.x

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