Differences Between Patients Who Do and Do Not Adhere to Antiretroviral Therapy

Nurses are often frustrated with HIV-infected patients who do not adhere to antiretroviral (ARV) therapy. To help patients adhere, it is first necessary to know the patient’s stage of behavior change, and then to identify the specific factors determining that patient’s behavior. The purpose of this study was to compare the health beliefs and behaviors of patients in the maintenance stage (optimum adherers) with those in the relapse stage (defaulters). Themes were extracted from open essay-type questions. The general profile for patients in the relapse stage was one of disempowerment, passiveness, and being a victim of ARVs. The profile for patients who achieved optimum ARV adherence levels illustrated empowerment, control, proactiveness, and being a victor rather than a victim of ARVs. Emerging themes were linked to the theoretical determinants of behavior change, and suggestions were made on how to help patients adhere to ARV regimens.