HIV Patients' Mental Health Affects How Seriously They Take Treatment

July 01, 1998

GENEVA, Switzerland--HIV patients who feel they have a meaningful life and are well cared for take their treatment more seriously than those who don't, a new University of California San Francisco study has found.

The study, based on surveys with 727 patients in seven U.S. cities, found that patients who feel they are part of their community and are involved in their own care are more likely to take their medication, keep medical appointments, and follow their health care providers' advice. However, HIV patients who feel detached from their surroundings or are depressed are more apt to disregard medical treatment, according to study findings.

"The psychological well-being of HIV patients plays a role in their adherence to treatment," said William Holzemer, RN, PhD, UCSF professor of nursing, chair of the UCSF School of Nursing's Department of Community Health Systems, and the study's principal investigator.

The findings, Holzemer said, are an important step in the continuous effort to identify reasons why some HIV patients disregard treatment even though it may help them fight the disease. A lack of adherence to medication and treatment has recently been identified as a key problem in the fight against HIV and the onset of AIDS.

Now that the research has shown some of the reasons why patients may be lax about their treatment, health care providers can take steps to fight those situations, Holzemer said.

By knowing that depression, for example, influences patients' adherence to treatment, health care providers can more thoroughly screen patients for the condition and treat it, Holzemer said. Researchers also plan to find ways to help patients feel more actively involved in their own care in hopes that they will take it more seriously as a result, Holzemer said.

The study, one of the largest ever on the subject, used a survey to assess the mental and emotional states of patients and to determine how this influenced whether they took treatment seriously.

The people surveyed represented a cross section of HIV patients nationwide. About 77 percent of the participants were male. About 43 percent of them were non-whites, and the average age was 39 years old. The study found that neither age nor gender are factors in whether people took their medication or followed providers' instructions. Drug use isn't a factor either, the study found.

Those findings, Holzemer said, are key to eliminating biases among health care workers who believe that particular HIV patients are less likely to follow their treatment and advice. Too often, he said, particular patients are put into categories when they shouldn't be.

"This shows that while people may make assumptions about who is going to adhere to their treatment, their guess may not be very good," Holzemer said.

University of California - San Francisco

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