Self Effikasi pada ODHA

The purpose of this study was to examine the relationship of sociodemographic characteristics,
patient perceptions, and patient characteristics including spirituality, self-reported adherence, and
highly active antiretroviral therapy. The convenience sample consisted of 120 English-speaking
adults (60% male, 35% female, 5% transgendered) with HIV/AIDS from two HIV service
agencies in a large metropolitan city in the southeastern United States. The mean self-reported
adherence was 83.1% (SD = 15.7%). Adherence was significantly correlated with perceived
support and absence of barriers, strong intentions to adhere, perceived effectiveness of the
medications, higher levels of perceived general health, fewer years of HIV disease, and fewer
years on antiretroviral medications. Existential well-being (e.g., viewing life as positive and
having meaning) was a weak significant correlate. Backward regression analysis was conducted
to identify a parsimonious model of predictors of adherence. The final model included presence
of support and absence of barriers, fewer years of HIV infection, no current alcohol use,
perceived severity of HIV, existential well-being, and male gender. This model explained 19.4%
of the variance in adherence (observed F[6, 100] = 5.6, p < .0001).
We identified nine studies meeting our inclusion criteria. Adherence to ART in Cameroon
has risen steadily between 2000 and 2010, corresponding to reductions in the cost of medication.
The factors associated with adherence to ART in Cameroon are grouped into patient, medication
and disease related factors. We also identified factors related to the health system and the patientprovider relationship. In the CAMPS trial, education, side effects experienced and number of
reminder methods were found to improve adherence, but only using multiple reminder methods
was associated with better adherence in all the regression models (Adjusted Odds Ratio [AOR]
4.11, 95% Confidence Interval [CI] 1.89, 8.93; p<0.001; model IV).
The purpose of this study was to examine the relationship of sociodemographic
characteristics, patient perceptions, and patient characteristics including spirituality, self-reported
adherence, and highly active antiretroviral therapy. The convenience sample consisted of 120
English-speaking adults (60% male, 35% female, 5% transgendered) with HIV/AIDS from two
HIV service agencies in a large metropolitan city in the southeastern United States. The mean
self-reported adherence was 83.1% (SD = 15.7%).
Adherence was significantly correlated with perceived support and absence of barriers,
strong intentions to adhere, perceived effectiveness of the medications, higher levels of perceived

general health, fewer years of HIV disease, and fewer years on antiretroviral medications.
Existential well-being (e.g., viewing life as positive and having meaning) was a weak significant
correlate. Backward regression analysis was conducted to identify a parsimonious model of
predictors of adherence. The final model included presence of support and absence of barriers,
fewer years of HIV infection, no current alcohol use, perceived severity of HIV, existential wellbeing, and male gender. This model explained 19.4% of the variance in adherence (observed F[6,
100] = 5.6, p < .0001).
There is a growing body of research aimed at identifying determinants of ART adherence
with a focus on developing interventions to reduce non-adherence
Beliefs about the importance of antiretroviral adherence and ability to take antiretroviral
medications as directed (adherence self-efficacy) were generally positive
Self-efficacy is associated with health behavior and medication adherence in persons living with
HIV infection (PLWH). This paper describes self-efficacy, medication adherence, and quality of
life (QOL), and it examines the relationships among these variables in PLWH in China. A crosssectional survey of 199 patients was completed using the HIV Self-Efficacy Questionnaire and
the QOL for Chinese HIV-Infected Questionnaire. Medication adherence was measured through
direct questioning of pill-taking behavior. Results showed that self-efficacy for disease
management was moderate, with a mean score of 6.61. Of the 199 patients, 157 (78.9%) reported
that medication adherence was higher than 90%. The scores for dimensions of QOL ranged from
33.1 to 81.4, with six dimensions lower than 60. Stepwise regression analyses showed that selfefficacy, medication adherence, and drug use were significant predictors of QOL. These results
suggest a need for intervention programs to improve self-efficacy and quality of life in Chinese
PLWH.
Adherence self-efficacy showed significant correlations with medication adherence and both
HIV biological outcomes Adherence self-efficacy had direct effects on viral load, but not CD4
count. Mediation analyses indicated that self-reported adherence partially mediated the
relationship between adherence selfefficacy and viral load. Cognitive-oriented interventions
aimed at facilitating adherence self-efficacy may be effective in improving both medication
adherence and HIV health. If facilitating confidence improves HIV health, then health care
providers can make a strong impact by spending a few short minutes themselves and/or
partnering with behavioral health clinicians using techniques like

motivational enhancement.
Nonadherence to combination antiretroviral medications is common and is associated
with increased levels of plasma HIV. Programs and clinical efforts to improve medication taking
should strive to integrate medications better into patients' daily routines and to improve patients'
confidence in their ability to take medications correctly.Almost all of those who are currently on
ART are on a regimen of three or more ARVs (Grierson et al., 2000). The likelihood of a
patients adherence to a given regimen declines with polypharmacy, the frequency of dosing, the
frequency and severity of sideeffects, and the complexity of the regimen (Williams and
Friedland, 1997). Drug hypersensitivity is common in patients with HIV and regimenassociated
toxicity is a common predictor of, and reason for suboptimal adherence, which has been
identified across many studies. Sideeffects associated with each individual ARV medicine have
been well documented and, while not universal for every patient, can be predicted. Although
these sideeffects usually subside after the first few weeks of therapy, for some people they
persist. The anticipation and fear of sideeffects also have an impact on adherence. Poor
adherence has also been associated with patients desire to avoid
embarrassing sideeffects (like sweating) in certain situations such as on a date or at a job
interview (Burgos et al., 1998).Dietary restrictions add to the complexity of ART and often
require adjustments in lifestyle. Patients can find their meal schedule compromised by ARVs that
need to be taken on an empty stomach. This can be particularly difficult if workmates, family or
friends are unaware of the patients HIV status (Grierson et al., 2000). Complicated regimens
with rigid dosing intervals may also interrupt sleep. The physical aspects of a particular
medication (for example, taste, size or formulation) may also affect a
patients ability to adhere. The generic fixed dose combination Triomune, which is provided by
the Global Fund/MoH consists of three ARVs (lamivudine, stavudine and nevirapine) in a single
pill. However, PEPFAR provides these same ARVs as three separate pills. As a result,
patients taking the separate pills have to take three times as many pills as those on
Triomune, with significant implications for adherence. A study in Senegal reveals that
a high pill burden is associated with poor adherence among patients who have to take
a large number of ARV pills (Dansburg et al., 2003).

For people on ART, a typical combination of medicines consists of three ARVs, plus
other medication to prevent opportunistic infections. This can result in a high pill
burden, taking medicine three times a day, dietary and dosing idiosyncrasies, large
capsules or tablets, and specific storage instructions. The complexity of this regimen
may have a significant impact on a patients ability to adhere. Additional medications
taken for symptomatic relief (such as analgesics, cough remedies and other common
treatments) in patients with advanced disease further add to the pill burden and
toxicity. In Uganda, firstline treatment involves the use of the following combinations:
lamivudine, stavudine, and nevirapine or efavirenz; and zidovudine, lamivudine, and
nevirapine or efavirenz. Secondline medicines used are didanosine; lopinivir or
ritonivir; and stavudine or zidovudine.
Dietary restrictions add to the complexity of ART and often require adjustments in
lifestyle. Patients can find their meal schedule compromised by ARVs that need to be
taken on an empty stomach. This can be particularly difficult if workmates, family or
friends are unaware of the patients HIV status (Grierson et al., 2000). Complicated
regimens with rigid dosing intervals may also interrupt sleep. The physical aspects of a
particular medication (for example, taste, size or formulation) may also affect a
patients ability to adhere.
These include the number of pills prescribed, the complexity of the regimen (dosing
frequency and food instruction), the specific type of ARV and medication sideeffects.
The complexity of the regimen and sideeffects caused by it are clearly associated with
suboptimal adherence (Machtinger and Bangsberg, 2005).
Hal tersebut termasuk jumlah pil yang diresepkan, kompleksitas dari rejimen (dosing frekuensi
dan makanan instruksi), jenis tertentu dari sideeffects ARV dan obat-obatan.
Kompleksitas rejimen dan efek samping berhubungan dengan ketidakpatuhan (Machtinger dan
Bangsberg, 2005).
This includes the patients overall satisfaction and trust in the provider and clinic staff;
the patients opinion of the providers competency; the providers willingness to
include the patient in the decisionmaking process; the affective tone of the relationship

(e.g. warmth, openness, cooperation); the compatibility of race/ethnicity between

patient and provider; and the adequacy of referral.