Identifying factors influencing medication non-adherence in HIV-positive patients in Iran using exploratory factor analysis approach

Keshtkar, Narges; Masoudi Asl, Iravan; Hessam, Somayeh; Mahfoozpour, Soad

[Home ] [Archive]

[ فارسی ]

Journal of Ilam University of Medical Sciences

Main Menu

Home

Journal Information

Articles archive

Publication Ethics

Peer Review Process

Indexing Databases

For Authors

For Reviewers

Subscription

Contact us

Site Facilities

Google Scholar Metrics

	All	Since 2019
Citations	6551	3806
h-index	27	21
i10-index	195	86

Search in website

Receive site information

Registered in

Volume 31, Issue 3 (8-2023)

Journal of Ilam University of Medical Sciences 2023, 31(3): 47-61

Back to browse issues page

Identifying factors influencing medication non-adherence in HIV-positive patients in Iran using exploratory factor analysis approach

Narges Keshtkar¹

, Iravan Masoudi Asl ^*

², Somayeh Hessam¹

, Soad Mahfoozpour¹

1- Dept of Health Services Management, Faculty of Management, South Tehran Branch, Islamic Azad University, Tehran, Iran
2- Dept of Health Services Management, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran , drmasoudiasl@gmail.com

Abstract: (827 Views)

Introduction: Non-adherence to medication in HIV-positive patients leads to the occurrence of HIV-related diseases and ultimately reduces the quality of life and immune system function of these patients. Therefore, the present study was conducted to identify and explain the factors that influence medication non-adherence in HIV-positive Iranian patients.
Material & Methods: The present applied study was conducted in 2020-2021 using the descriptive method. First, by reviewing the research literature and interviewing experts in the field of HIV treatment, the main factors influencing medication non-adherence in HIV-positive patients were identified, based on which the research questionnaire was designed. Data were collected from 590 HIV-positive patients and analyzed using exploratory factor analysis and SPSS23 and LISREL software.
Findings: Four factors, namely organizational factors (16 items), individual factors (19 items), educational factors (7 items), and communication factors (7 items) were identified as effective factors for medication non-adherence in HIV-infected patients. Communication factors, individual factors, educational factors, and organizational factors with factor loadings of 0.76, 0.74, 0.73, and 0.71, respectively, had an impact on medication non-adherence in HIV-positive patients.
Discussion & Conclusion: To improve medication adherence among HIV patients, behavioral disease counseling experts and therapists should pay more attention to communication factors (improving patients social support from family and friends) and individual factors (not coping with the disease state and the effects of stigma and disclosing the disease).

Keywords: Exploratory factor analysis, HIV/AIDS, Medication adherence, Patient safety

Full-Text [PDF 937 kb] (332 Downloads)

Type of Study: Research | Subject: infectious diseases
Received: 2022/07/17 | Accepted: 2022/12/4 | Published: 2023/09/6

References

1. F Farhoudi B, Ghalekhani N, Afsar Kazerooni P, Namdari Tabar H, Tayeri K, Gouya MM, et al. Cascade of care in people living with HIV in Iran in 2019; how far to reach UNAIDS/WHO targets. AIDS Care 2022; 34:590-96. doi: 10.1080/09540121.2021.1944603.

2. Stover J, Glaubius R, Kassanjee R, Dugdale CM. Updates to the Spectrum/AIM model for the UNAIDS 2020 HIV estimates. J Int AIDS Soc 2021;24: e25778. doi: 10.1002/jia2.25778.

3. Ellsworth GB, Burke LA, Wells MT, Mishra S, Caffrey M, Liddle D, et al. Randomized Pilot Study of an Advanced Smart-Pill Bottle as an Adherence Intervention in Patients with HIV on Antiretroviral Treatment. J Acquir Immune Defic Syndr 2021; 86:73-80. doi: 10.1097/QAI.0000000000002519.

4. Buh A, Deonandan R, Gomes J, Krentel A, Oladimeji O, Yaya S. Adherence barriers and interventions to improve ART adherence in Sub-Saharan African countries: A systematic review protocol. PLoS One 2022;17: e0269252. doi: 10.1371/journal.pone.0269252.

5. Ritchwood TD, Bishu KG, Egede LE. Trends in healthcare expenditure among people living with HIV/AIDS in the United States: evidence from 10 Years of nationally representative data. Int J Equity Health 2017; 16:188. doi: 10.1186/s12939-017-0683-y.

6. Whiteley LB, Olsen EM, Haubrick KK, Odoom E, Tarantino N, Brown LK. A Review of Interventions to Enhance HIV Medication Adherence. Curr HIV/AIDS Rep 2021; 18:443-57. doi: 10.1007/s11904-021-00568-9.

7. Khalili H, Rohani R, Seyedalinaghi S, Hajiabdolbaghi M, Dashti-Khavidaki S, Talasaz AH. Adherence to Antiretroviral Therapy Among Iranian HIV/AIDS Patients. Curr Clin Pharmacol 2012; 7:111-15. doi: 10.2174/157488412800228910.

8. Flensburg O, Richert T, Väfors Fritz M. Parents of adult children with drug addiction dealing with shame and courtesy stigma. Drugs: Edu Prev Policy 2022; 7-19, doi:10.1080/09687637.2022.2099249.

9. Byrd KK, Hou JG, Hazen R, Kirkham H, Suzuki S, Clay PG, et al. Patient-Centered HIV Care Model Team. Antiretroviral Adherence Level Necessary for HIV Viral Suppression Using Real-World Data. J Acquir Immune Defic Syndr 2019; 82:245-51. doi: 10.1097/QAI.0000000000002142.

10. Benson C, Wang X, Dunn KJ, Li N, Mesana L, Lai J, et al. Antiretroviral Adherence, Drug Resistance, and the Impact of Social Determinants of Health in HIV-1 Patients in the US. AIDS Behav 2020; 24:3562-73. doi: 10.1007/s10461-020-02937-8.

11. Morowatisharifabad MA, Movahed E, Farokhzadian J, Nikooie R, Hosseinzadeh M, Askarishahi M, et al. Antiretroviral therapy adherence and its determinant factors among people living with HIV/AIDS: a case study in Iran. BMC Res Notes 2019; 12:162. doi: 10.1186/s13104-019-4204-5.

12. Langebeek N, Gisolf EH, Reiss P, Vervoort SC, Hafsteinsdóttir TB, Richter C, et al. Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: a meta-analysis. BMC Med 2014; 12:142. doi: 10.1186/PREACCEPT-1453408941291432.

13. Mugavero MJ, Amico KR, Horn T, Thompson MA. The state of engagement in HIV care in the United States: from cascade to continuum to control. Clin Infect Dis 2013; 57:1164-71. doi: 10.1093/cid/cit420.

14. Langebeek N, Gisolf EH, Reiss P, Vervoort SC, Hafsteinsdóttir TB, Richter C, et al. Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: a meta-analysis. BMC Med 2014; 12:142. doi: 10.1186/PREACCEPT-1453408941291432.

15. Camacho G, Kalichman S, Katner H. Anticipated HIV-Related Stigma and HIV Treatment Adherence: The Indirect Effect of Medication Concerns. AIDS Behav 2020; 24:185-191. doi: 10.1007/s10461-019-02644-z.

16. Schotanus-Dijkstra M, Drossaert CHC, Pieterse ME, Boon B, Walburg JA, Bohlmeijer ET. An early intervention to promote well-being and flourishing and reduce anxiety and depression: A randomized controlled trial. Internet Interv 2017; 9:15-24. doi: 10.1016/j.invent.2017.04.002.

17. Kimera E, Vindevogel S, De Maeyer J, Reynaert D, Engelen AM, Nuwaha F, et al. Challenges and support for quality of life of youths living with HIV/AIDS in schools and larger community in East Africa: a systematic review. Syst Rev 2019; 8:64. doi: 10.1186/s13643-019-0980-1.

18. Spaan P, van Luenen S, Garnefski N, Kraaij V. Psychosocial interventions enhance HIV medication adherence: A systematic review and meta-analysis. J Health Psychol 2020; 25:1326-40. doi: 10.1177/1359105318755545.

19. Cook D, Rocker G. Dying with dignity in the intensive care unit. N Engl J Med 2014; 370:2506-14. doi: 10.1056/NEJMra1208795.

20. Guo Q, Jacelon CS. An integrative review of dignity in end-of-life care. Palliat Med2014; 28:931-40. doi: 10.1177/0269216314528399.

21. Pihl E, Fridlund B, Mårtensson J. Patients' experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis. Scand J Caring Sci 2011; 25:3-11. doi: 10.1111/j.1471-6712.2010.00780. x.

22. Buh A, Deonandan R, Gomes J, Krentel A, Oladimeji O, Yaya S. Adherence barriers and interventions to improve ART adherence in Sub-Saharan African countries: A systematic review protocol. PLoS One 2022;17: e0269252. doi: 10.1371/journal.pone.0269252.

23. Abdulai MA, Mevissen FEF, Marien V, Ruiter RAC, Owusu-Agyei S, Asante KP, et al. A qualitative analysis of factors influencing the implementation of antiretroviral treatment adherence policy in Ghana: stakeholders’ perspective. Health Res Policy Syst 2023; 21:54. doi: 10.1186/s12961-023-01010-9.

24. Chory A, Callen G, Nyandiko W, Njoroge T, Ashimosi C, Aluoch J, et al. A Pilot Study of a Mobile Intervention to Support Mental Health and Adherence Among Adolescents Living with HIV in Western Kenya. AIDS Behav 2022; 26:232-42. doi: 10.1007/s10461-021-03376-9.

25. Sumari-de Boer IM, Ngowi KM, Sonda TB, Pima FM, Masika Bpharm LV, Sprangers MAG, et al. Effect of Digital Adherence Tools on Adherence to Antiretroviral Treatment Among Adults Living with HIV in Kilimanjaro, Tanzania: A Randomized Controlled Trial. J Acquir Immune Defic Syndr 2021; 87:1136-44. doi: 10.1097/QAI.0000000000002695.

26. Okonji EF, Mukumbang FC, Orth Z, Vickerman-Delport SA, Van Wyk B. Psychosocial support interventions for improved adherence and retention in ART care for young people living with HIV (10-24 years): a scoping review. BMC Public Health 2020; 20:1841. doi: 10.1186/s12889-020-09717-y.

27. Glasner S, Patrick K, Ybarra M, Reback CJ, Ang A, Kalichman S, et al. Promising outcomes from a cognitive behavioral therapy text-messaging intervention targeting drug use, antiretroviral therapy adherence, and HIV risk behaviors among adults living with HIV and substance use disorders. Drug Alcohol Depend 2022; 231:109229. doi: 10.1016/j.drugalcdep.2021.109229.

28. Negash T, Ehlers V. Personal factors influencing patients' adherence to ART in Addis Ababa, Ethiopia. J Assoc Nurses AIDS Care 2013; 24:530-8. doi: 10.1016/j.jana.2012.11.004.

29. Habibpour K, Safari R. Comprehensive guide to the use of SPSS in survey research. MotafkaranPublishing. 2009.

30. Shah R, Goldstein SM. Use of structural equation modeling in operations management research: Looking back and forward. J Oper Manag 2006; 24:148-69. doi: 10.1016/j.jom.2005.05.001.

31. Kline R. Principles and practice of structural equation modeling. New York: Guilford Press. 2010; 427pp.

32. Heydari M, Mehraeen M, Keshani P, Faghih M. The Association Between Mental Health of HIV Patients and Antiretroviral Medication Adherence. Int J High Risk Behav Addict 2021;10: doi:10.5812/ijhrba.102149.

33. Dalmida SG, McCoy K, Koenig HG, Miller A, Holstad MM, Thomas T, et al. Examination of the Role of Religious and Psychosocial Factors in HIV Medication Adherence Rates. J Relig Health 2017; 56:2144-61. doi: 10.1007/s10943-017-0377-1.

34. Mehari M, Kiros N, Yemane A, Asghedom N, Debesay S, Tekeste T. Factors affecting treatment adherence among HIV-positive patients in Eritrea. Int Biol Biomed J 2017; 3:150-6.

35. Yuan Y, L'italien G, Mukherjee J, Iloeje UH. Determinants of discontinuation of initial highly active antiretroviral therapy regimens in a US HIV-infected patient cohort. HIV Med 2006; 7:156-62. doi: 10.1111/j.1468-1293.2006.00355. x.

36. Le PM, Nguyen PT, Nguyen HV, Bui DH, Vo SH, Nguyen NV, et al. Adherence to highly active antiretroviral therapy among people living with HIV and associated high-risk behaviours and clinical characteristics: A cross-sectional survey in Vietnam. Int J STD AIDS 2021; 32:911-18. doi: 10.1177/09564624211002405.

Send email to the article author

Add your comments about this article

Ethics code: IR.IAU.SRB.REC.1399.209

Mendeley

Zotero

RefWorks

Keshtkar N, Masoudi Asl I, Hessam S, Mahfoozpour S. Identifying factors influencing medication non-adherence in HIV-positive patients in Iran using exploratory factor analysis approach. J. Ilam Uni. Med. Sci. 2023; 31 (3) :47-61
URL: http://sjimu.medilam.ac.ir/article-1-7650-en.html

Rights and permissions
	This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Volume 31, Issue 3 (8-2023)

Back to browse issues page

Persian site map - English site map - Created in 0.15 seconds with 41 queries by YEKTAWEB 4657