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A Social-Ecological View of Barriers and Facilitators for HIV Treatment Adherence: Interviews with Puerto Rican HIV Patients.

Castro EM, Santiago LE, Jiménez JC, Dávila-Vargas D, Rosal MC - PLoS ONE (2015)

Bottom Line: The top four sub-categories linked to high number of codes are treatment regimen (D = 4), health status perception (D = 3), interpersonal relations (D = 3) and health system (D = 3).The results of this study suggest the interconnection of HIV treatment adherence barriers at various system levels.Future studies on HIV treatment barriers should explore these interactions and investigate the possible synergistic effect on non-adherent behavior.

View Article: PubMed Central - PubMed

Affiliation: Clinical Psychology Programs, Ponce School of Medicine and Health Sciences, Ponce, Puerto Rico, United States of America; Psychiatry Department, Ponce School of Medicine and Health Sciences, Ponce, Puerto Rico, United States of America.

ABSTRACT

Purpose: To identify perceived barriers and facilitators for HAART adherence among people living with HIV/AIDS in Southern Puerto Rico using a Social Ecological framework.

Patients and methods: Individual in-depths interviews were conducted with 12 HIV patients with a history of HAART non-adherence. Interviews were audio-taped and transcribed. Content analysis was performed for each transcribed interview by three independent coders using a codebook. Using Atlas TI, super-codes and families were generated to facilitate the categorization tree as well as grounded analyses and density estimates.

Results: Most participants reported a monthly income of $500 or less (n = 7), a high school education level (n = 7), being unemployed (n = 9) and being recipients of government health insurance (n = 11). Three out of six women reported living alone with their children and most men informed living with their parents or other relatives (n = 4). For the grounded analyses, the top four sub-categories linked to high number of quotations were mental health barriers (G = 32) followed by treatment regimen (G = 28), health system (G = 24) and interpersonal relations (G = 16). The top four sub-categories linked to high number of codes are treatment regimen (D = 4), health status perception (D = 3), interpersonal relations (D = 3) and health system (D = 3).

Conclusion: The results of this study suggest the interconnection of HIV treatment adherence barriers at various system levels. Future studies on HIV treatment barriers should explore these interactions and investigate the possible synergistic effect on non-adherent behavior.

No MeSH data available.


Interview guide (Prompt questions not included).
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pone.0125582.g001: Interview guide (Prompt questions not included).

Mentions: The principal investigator and three members of the research team, with expertise in qualitative research design, developed the interview guide (Fig 1). Questions were designed following the research question and the framework of the Social Ecological Model and techniques proposed by Kvale (1996) [21] (e.g. introducing questions, probes, etc.). The interview guide was pilot-tested with two adult HIV patients for clarity and relevance of the questions, which resulted in slight modifications of some of the questions and the addition of prompts. Questions were open ended in order to facilitate participants’ insightful response and prompts were used to assist in focused elaboration and depth in participants’ responses. Questions addressed patient-perceived barriers and facilitators of HAART adherence at various systems’ levels (e.i. individual, micro-system, meso-system, etc.).


A Social-Ecological View of Barriers and Facilitators for HIV Treatment Adherence: Interviews with Puerto Rican HIV Patients.

Castro EM, Santiago LE, Jiménez JC, Dávila-Vargas D, Rosal MC - PLoS ONE (2015)

Interview guide (Prompt questions not included).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4589346&req=5

pone.0125582.g001: Interview guide (Prompt questions not included).
Mentions: The principal investigator and three members of the research team, with expertise in qualitative research design, developed the interview guide (Fig 1). Questions were designed following the research question and the framework of the Social Ecological Model and techniques proposed by Kvale (1996) [21] (e.g. introducing questions, probes, etc.). The interview guide was pilot-tested with two adult HIV patients for clarity and relevance of the questions, which resulted in slight modifications of some of the questions and the addition of prompts. Questions were open ended in order to facilitate participants’ insightful response and prompts were used to assist in focused elaboration and depth in participants’ responses. Questions addressed patient-perceived barriers and facilitators of HAART adherence at various systems’ levels (e.i. individual, micro-system, meso-system, etc.).

Bottom Line: The top four sub-categories linked to high number of codes are treatment regimen (D = 4), health status perception (D = 3), interpersonal relations (D = 3) and health system (D = 3).The results of this study suggest the interconnection of HIV treatment adherence barriers at various system levels.Future studies on HIV treatment barriers should explore these interactions and investigate the possible synergistic effect on non-adherent behavior.

View Article: PubMed Central - PubMed

Affiliation: Clinical Psychology Programs, Ponce School of Medicine and Health Sciences, Ponce, Puerto Rico, United States of America; Psychiatry Department, Ponce School of Medicine and Health Sciences, Ponce, Puerto Rico, United States of America.

ABSTRACT

Purpose: To identify perceived barriers and facilitators for HAART adherence among people living with HIV/AIDS in Southern Puerto Rico using a Social Ecological framework.

Patients and methods: Individual in-depths interviews were conducted with 12 HIV patients with a history of HAART non-adherence. Interviews were audio-taped and transcribed. Content analysis was performed for each transcribed interview by three independent coders using a codebook. Using Atlas TI, super-codes and families were generated to facilitate the categorization tree as well as grounded analyses and density estimates.

Results: Most participants reported a monthly income of $500 or less (n = 7), a high school education level (n = 7), being unemployed (n = 9) and being recipients of government health insurance (n = 11). Three out of six women reported living alone with their children and most men informed living with their parents or other relatives (n = 4). For the grounded analyses, the top four sub-categories linked to high number of quotations were mental health barriers (G = 32) followed by treatment regimen (G = 28), health system (G = 24) and interpersonal relations (G = 16). The top four sub-categories linked to high number of codes are treatment regimen (D = 4), health status perception (D = 3), interpersonal relations (D = 3) and health system (D = 3).

Conclusion: The results of this study suggest the interconnection of HIV treatment adherence barriers at various system levels. Future studies on HIV treatment barriers should explore these interactions and investigate the possible synergistic effect on non-adherent behavior.

No MeSH data available.