Basic Information about the Upcoming Study
The current paper provides a review of literature on the topic of the relationship between anti-HIV treatment adherence and social support among African American HIV-positive females. It was established that social support generally increases the levels of HIV-treatment compliance, but further studies may be needed to discover the nuances of this relationship. Both qualitative and quantitative methods can be used to research such topics (Campbell & Stanley, 1963). The planned study may include both types of methods; it is likely that it will employ certain statistical procedures such as the t-test, ANOVA, or the calculation of correlation coefficients (Field, 2013).
Literature Review
The article by Boarts, Bogart, Tabak, Armelie, & Delahanty (2008) reports a study aimed at finding the factors associated with low levels of adherence to antiretroviral therapy among individuals with HIV. The authors gathered self-reports from 57 patients of a medical institution and conducted a logistic regression to find the predictors of non-adherence. Racial discrimination significantly predicted non-adherence among the patients, while discrimination related to HIV+ status and sexual orientation did not predict non-adherence. It is recommended to address racial discrimination issues to address the problem.
The qualitative research by Cené, Akers, Lloyd, Albritton, Hammond, & Corbie-Smith (2011) was conducted in North Carolina and included 93 African American participants and 37 multiethnic key informants. The aim was to comprehend the mutual relationship between the community and individual factors by using a social network model. Four themes pertaining to this relationship which mediated the HIV risk emerged, namely, “interpersonal processes, community structural environment, social disorder, and civic engagement” (Cené et al., 2011, p. 737). It is recommended for doctors to perform universal HIV testing and take into account the degree of stigma or support from patients’ local communities while addressing the HIV testing and treatment issues.
The article by Edwards (2006) reports a qualitative study based on semi-structured interviews with 20 African American women, which was aimed at exploring the views on social support and its impact on HIV medication adherence. It was found out that support from family members and being a mother of a young child served as facilitators of HIV medication adherence, whereas the feeling of not being loved, perceived stigma, problems in the relationships, and the presence of a husband who is also HIV-positive served as barriers to HIV treatment adherence. It is stressed that emotional support and instrumental support are what these women often desire.
The work by Edwards, Irving, Amutah, & Sydnor (2012) was aimed at exploring unexpected sources of social support among HIV-positive African American women which facilitate anti-HIV medication adherence. The authors conducted a phenomenological study of 20 HIV-positive respondents from the population of African American women living with HIV. The main finding of the study was that young children, aged up to 10-12 (and not adult relatives), often act as a powerful source of social support, taking care of their ill mothers and stimulating them to regularly take anti-HIV drugs. It is recommended to promote intervention programs aimed at increasing social support for HIV-infected women coming from adult members of their families.
The study by Feaster, Brincks, Mitrani, Prado, Schwartz, & Szapocznik (2010) was aimed at comparing a family therapy intervention for increasing HIV medication compliance labeled Structural Ecosystems Therapy (SET) to person-centered therapy. The sample consisted of 156 rural African American HIV-positive mothers, who were provided with SET. This therapy caused high levels of medication compliance at significantly more frequent rates than a person-centered approach, and also resulted in a lower number of quarrels of participants with their relatives. It is concluded that SET may be recommended for increasing HIV treatment compliance among African American women from rural families.
The study by Kalichman, Catz, & Ramachandran (1999) was aimed at investigating the relationship between HIV-therapy adherence and access to medical care, on the one hand, and levels of education and health literacy, on the other. 138 African Americans participated in the study. Statistical analysis showed that both the low levels of education and poor health literacy were important factors associated with low levels of adherence to HIV treatment. It is recommended to implement interventions aimed at addressing low health literacy levels for individuals with limited reading skills.
The article by Foley (2005) reports the results of a study of perceptions and perspectives of medical care providers in the city of Philadelphia pertaining to serving HIV-positive African immigrants, which was aimed at exploring the structural and cultural barriers faced by African HIV-positive female immigrants. It was found out that the legal status, language barriers, wrong understanding of the ways of HIV transmission, the dearth of awareness of anti-HIV treatment, and the fear of the American health care system are among the serious barriers that these women face. It is recommended to create the appropriate educational programs for these immigrants.
Logie, James, Tharao, & Loutfy (2013) studied a non-random sample of 173 HIV-positive African, Caribbean, and Black females from Ontario, Canada so as to investigate the relationships between HIV-related stigma, levels of depression, and discrimination pertaining to gender and race. The results of surveying were processed using hierarchical block regression, as well as moderation/mediation analyses. As a result, an association between HIV stigmatization and depression was revealed. Also, coping was a mediator in the association between HIV-stigmatization and depression to some extent; in addition, high coping was associated with low levels of depression. It is stressed that multi-component interventions and programs aimed at stigma reduction are paramount to helping the HIV-positive population.
Meade, Hansen, Kochman, & Sikkema (2009) studied a total of 168 HIV-positive persons (50% women, 69% Black, age: mean=42.3, SD=6.8) who had suffered from childhood sexual abuse. A multivariable logistic regression demonstrated that: a) outpatient treatment was not associated with Black race, low levels of social support, or abstention from illegal substances; b) the use of emergency services was associated with alcohol consumption, symptoms of HIV, and illegal substance use; c) low levels of HIV treatment compliance were associated with symptoms of trauma and low levels of social support. It is stressed that quite a large minority of participants did not comply with the treatment guidelines. It is recommended to address such factors as substance use, symptoms of trauma, and low social support, to reduce their interference with anti-HIV medication use.
Remien, Hirky, Johnson, Weinhardt, Whittier, & Le (2003) provide the results of a qualitative study of a diverse sample of 110 HIV+ participants who were interviewed for an in-depth investigation of their experiences, perspectives, etc., related to HIV treatment. It was found that changes in the worldview, attitudes, daily routine and significant life events were associated with an impact on HIV-treatment adherence. Furthermore, certain people intentionally avoided HIV medication to relieve its physical side effects. It is recommended to pay attention to individual factors while attempting to address HIV medication adherence problems.
References
Boarts, J. M., Bogart, L. M., Tabak, M. A., Armelie, A. P., & Delahanty, D. L. (2008). Relationship of race-, sexual orientation-, and HIV-related discrimination with adherence to HIV treatment: A pilot study. Journal of Behavioral Medicine, 31, 445-451. Web.
Campbell, D. T., & Stanley, J. C. (1963). Experimental and quasi-experimental designs for research. Boston, MA: Houghton Mifflin.
Cené, C. W., Akers, A. Y., Lloyd, S. W., Albritton, T., Hammond, W. P., & Corbie-Smith, G. (2011). Understanding social capital and HIV risk in rural African American communities. Journal of General Internal Medicine, 26(7), 737-744.
Edwards, L. V. (2006). Perceived social support and HIV/AIDS medication adherence among African American women. Qualitative Health Research, 16(5), 679-691. Web.
Edwards, L. V., Irving, S. M., Amutah, N. N., & Sydnor, K. D. (2012). Am I my mother’s keeper? Children as unexpected sources of social support among African American women living with HIV-AIDS. Journal of Black Studies, 43(5), 571-595. Web.
Feaster, D. J., Brincks, A. M., Mitrani, V. B., Prado, G., Schwartz, S. J., & Szapocznik, J. (2010). The efficacy of structural ecosystems therapy for HIV medication adherence with African American women. Journal of Family Psychology, 24(1), 51-59. Web.
Field, A. (2013). Discovering statistics using IBM SPSS statistics (4th ed.). Thousand Oaks, CA: SAGE Publications.
Foley, E. E. (2005). HIV/AIDS and African immigrant women in Philadelphia: Structural and cultural barriers to care. AIDS Care, 17(8), 1030-1043. Web.
Kalichman, S. C., Catz, S., & Ramachandran, B. (1999). Barriers to HIV/AIDS treatment and treatment adherence among African-American adults with disadvantaged education. Journal of the National Medical Association, 91(8), 439-446. Web.
Logie, C., James, L., Tharao, W., & Loutfy, M. (2013). Associations between HIV-related stigma, racial discrimination, gender discrimination, and depression among HIV-positive African, Caribbean, and Black women in Ontario, Canada. AIDS Patient Care & STDs, 27(2), 114-122. Web.
Meade, C. S., Hansen, N. B., Kochman, A., & Sikkema, K. J. (2009). Utilization of medical treatments and adherence to antiretroviral therapy among HIV-positive adults with histories of childhood sexual abuse. AIDS Patient Care & STDs, 23(4), 259-266. Web.
Remien, R. H., Hirky, A. E., Johnson, M. O., Weinhardt, L. S., Whittier, D., & Le, G. M. (2003). Adherence to medication treatment: A qualitative study of facilitators and barriers among a diverse sample of HIV+ men and women in four U.S. cities. AIDS and Behavior, 7(1), 61-72.