Self-efficacy, medication beliefs and adherence to antiretroviral therapy by patients attending a health facility in Pretoria

Abstract

Background: Self-efficacy and medication beliefs are known factors that influence adherence to treatment in chronic medical conditions. We carried out a cross-sectional study on human immunodeficiency virus (HIV) -infected patients with the aim of determining the predictive relationship between these two variables and adherence to antiretroviral therapy (ART) at a health facility in Pretoria. Method: Participants’ medication beliefs were assessed using the Beliefs about Medicines Questionnaire. Self-efficacy was evaluated using the HIV Adherence Self-Efficacy Scale, and adherence to ART determined using the AIDS Clinical Trial Group questionnaire. Results: The mean age of the 232 participants was 40 years (standard deviation 15.6). Seventy per cent were females. Most had been on ART for over two years (87%), and 81.5% were adherent to at least 95% of the prescribed antiretroviral drugs. Nonadherence was highest in those on ART for more than three years (63%). The mean HIV Adherence Self-Efficacy score was 6.45 out of a possible 10. Beliefs held by the participants about the importance of (necessity) and concerns about ART in the management of HIV infection were generally positive. There was a mean score of 4.05 out of 5, indicating a strong belief in the use of ART. There was a strong association between adherence self-efficacy and ART adherence (p < 0.001) in the nonadherent participants. Regression analysis showed significance for adherence self-efficacy on ART nonadherence (p < 0.041), with adherence self-efficacy explaining 9.8% of the variance. Conclusion: Patients’ adherence self-efficacy explained a significant portion of variation in the nonadherence to ART, which suggests that low adherence self-efficacy is influential in ART nonadherence. Interventions aimed at improving adherence to ART should address adherence self-efficacy.