Dissertations, Theses, and Capstone Projects

Date of Degree

6-2022

Document Type

Dissertation

Degree Name

Ph.D.

Program

Social Welfare

Advisor

Alexis Kuerbis

Committee Members

Vicki Lens

Daniel Herman

Subject Categories

Public Health | Social Work

Keywords

ARV Treatment Adherence, HIV medication, PLWH

Abstract

Adherence to antiretroviral (ARV) treatment improves life expectancy and other health outcomes for people living with HIV (PLWH). It also minimizes their risk of transmitting HIV through sexual contact and is therefore a form of HIV prevention. However, many PLWH, specifically low-income PLWH of color who have been disproportionately impacted by the virus, face a multitude of barriers to ARV treatment adherence, making it much harder for them to take their medication as prescribed and remain engaged in care. This qualitative study based on Constructivist Grounded Theory explored the process by which 14 virally suppressed, low-income PLWH of color overcame barriers to ARV treatment adherence to achieve viral suppression. Data analysis revealed four factors that helped facilitate ARV treatment adherence. 1) Access to inclusive, nonjudgmental and destigmatizing quality medical care administered by culturally competent medical providers. 2) Trust in medical provider, the medical system, and medication. 3) Self-efficacy to accept the chronic medical condition and need to take medication to control it, be actively engaged in medical care, and take medication as prescribed. 4) Motivation, or having a will to live, something to live for (a life goal), a desire to be healthy and not be sick, and to not transmit HIV to others. These findings informed an emerging theory about ARV treatment adherence called the ARV Treatment Adherence Model. HIV policy and medical and social service providers interested in improving viral suppression rates for PLWH would benefit from developing interventions that minimize the competing barriers and reinforce the facilitators of ARV treatment adherence highlighted by the ARV Treatment Adherence Model.

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