Pretreatment ART Concerns Linked to Side Effects, Medication Nonadherence

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Treatment concerns predict the emergence of antiretroviral therapy side effects in people living with HIV.
Treatment concerns predict the emergence of antiretroviral therapy side effects in people living with HIV.

For patients living with HIV who are starting antiretroviral therapy (ART), pretreatment concerns are associated with increased side effects, according to results published in AIDS and Behavior.

Additionally, the results indicated the patients who experience side effects after 6 months of ART have low treatment adherence at 12 months.

The study included participants with HIV starting ART (n=76). Before initiating ART, each participant completed validated questionnaires that assessed their beliefs about ART, beliefs about medicine in general, perceived sensitivity to adverse effects of medications, depression, and anxiety. Participants completed the surveys again after 1 and 6 months of treatment.

At 1 month, 72.4% (n=55) of participants reported ≥1 moderate-to-severe treatment-related adverse event (TRAE). The number of symptoms ranged from 0 to 17, with a mean of 3.8. At 6 months, 59.2% (n=45) of participants reported ≥1 moderate-to-severe TRAE. The number of symptoms ranged from 0 to 17, with a mean of 3.2.

The 10 most commonly-reported TRAEs at 6 months were sleep difficulties (29%), sexual problems (26%), fatigue (24%), skin problems (22%), diarrhea (21%), altered sensation in hands or feet (18%), stiff joints (16%), nausea (16%), headache (16%), and pain (15%).

Although most participants (99%) had strong views about the necessity of treatment, 51% of participants had strong concerns about potential adverse consequences of ART.

Participants who reported pretreatment concerns about ART were more likely to experience TRAEs at both 1 month (P <.05) and 6 months of treatment (P <.005).

The number of TRAEs at 6 months predicted ART nonadherence at 12 months. Among participants with high adherence at 12 months, the mean number of TRAEs at 6 months was 2.5. For participants with low adherence at 12 months, the mean number of TRAEs at 6 months was 5.8 (t =−2.905; P =.005).

“[Our findings] suggest that exploring and addressing patients' concerns about ART before they initiate ART may prevent nonspecific side effects and improve patients' experience of treatment,” the researchers wrote.

Reference

Horne R, Chapman S, Glendinning E, Date HL, Guitart J, Cooper V. Mind matters: treatment concerns predict the emergence of antiretroviral therapy side effects in people with HIV [published online September 5, 2018]. AIDS Behav. doi:10.1007/s10461-018-2239-6

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