A Path Analysis on Adherence to Antiretroviral Therapy among HIV/ AIDS Patients at Dr. Moewardi Hospital, Surakarta using Health Belief Model
Background: HIV / AIDS (Acquired Immune Deficiency Syndrome) is still a health problem in the world including in Indonesia. Approximately 36.7 people are infected with HIV in the world and in Indonesia until March 2017 recorded 242,699 cases. The recorded amount does not reflect the real number in the community because HIV infection often does not show specific symptoms before entering the stage of AIDS. This study aimed to examine the application of the health belief model on adherence to antiretroviral therapy among HIV/ AIDS patients in Surakarta, Central Java.
Subject and Method: This was a cross sectional study conducted at Dr. Moewardi Hospital, Surakarta, Central Java, on February 2018. A total sample of 284 HIV/AIDS patients was selected for this study by exhaustive sampling. The dependent variable was ARV Adherence. The independent variables were perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. The data were collected using a questionnaire and analyzed by a path analysis.
Results: Adherence directly increased with self-efficacy (b= 2.10; 95% CI = 0.85 to 3.34; p= 0.001), perceived benefit (b= 2.08; 95% CI= 1.15 to 3.00; p <0.001), and cue to action (b= 3.61; 95% CI= 0.86 to 6.36; p= 0.010) but decreased with higher perceived barrier (b= 2.08; 95% CI= 1.15 to 3.00; p<0.001). Adherence indirectly decreased with higher perceived severity and perceived susceptibility.
Conclusion: Self-efficacy, perceived benefit, perceived barrier, and cue to action directly affect the adherence to antiretroviral therapy. Perceived severity and perceived susceptibility indirectly affect the adherence to antiretroviral therapy.
Keywords: ARV adherence, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy
Correspondence: Dyah Ayu Agustin. School of Health Sciences Kendedes, Malang, East Java. Email: firstname.lastname@example.org. Mobile: +6281316337006.
Journal of Health Promotion and Behavior (2018), 3(1): 48-55
Becerra JC, Bildstein LS, Gach JS (2016). Recent Insights into the HIV/AIDS Pandemic. Microbial Cell, 3(9): 451-475.
Burke E (2015). Ten Year Change in Blood Pressure Levels and Prevalence of Hypertension in Urban and Rural Cameroon. BMC Cardiovascular Disorders, 16(1): 1461–1473
Clutter DS, Jordan MR, Bertagnolio S, Shafer RW. 2016. HIV-1 Drug Resistance and Resistance Testing. Infection, Genetics and Evolution, 46: 292-307.
Garbelli A, Riva V, Crespan E, Maga G (2017). How to Win the HIV-1 Drug Resistance Hurdle Race: Running Faster or Jumping Higher? Biochemical Journal, 474(10): 1559-1577.
Horne R, Chapman SCE, Parham R, Freemantle N, Forbes A, Cooper V (2013). Understanding Patients’ Adherence Related Beliefs about Medicines Prescribed for Long Term Conditions: A Meta-Analytic Review of The Necessity Concerns Framework.PLoS ONE, 8(12): 1-24.
Jones CJ, Smith H, Llewellyn C (2014). Evaluating the Effectiveness of Health Belief Model Interventions in Improving Adherence: A Systematic Review. Health Psychology Review, 8(3): 253-269.
Kenmenkes RI, 2017. Laporan Kementerian Kesehatan Triwulan I. http://www.aidsindonesia.or.id/ckuploads/files/Laporan%20HIV%20AIDS%20TW%201%202017.pdf. Accessed August, 20 2017.
Kwarteng A, Ahuno ST, KwakyeNuako G (2017). The Therapeutic Landscape of HIV-1 via Genome Editing. AIDS Research and Therapy, 14(1): 32. doi: 10.1186/s1298101701578.
Iacob SA, Iacob DG, Jugulete G (2017). Improving the Adherence to Anti-retroviral Therapy, a Difficult but Essential Task for a Successful HIV Treatment Clinical Points of View and Practical Considerations. Frontiers in Pharmacology, 8: 831. doi: 10.3389/fphar.2017.00831.eCollection 2017.
Mattevi VS, Tagliari CF (2017). Pharmacogenetic Considerations in the Treatment of HIV. Pharmaco genomics, 18(1): 85-98.
Simpson V (2015). Models and Theories to Support Health Behavior Intervention and Program Planning. Health and Human Sciences, 1-5
Shubber Z, Mills EJ, Nachega JB, Vreeman R, Freitas M, Bock P, Nsanzimana S, Penazzato M, Appolo T, Doherty M, Ford N (2016). Patient-Reported Barriers to Adherence to Antiretroviral Therapy: A Systematic Review and Meta-Analysis. PLoS Medicine, 13(11): e1002183. doi: 10.1371/journal.pmed.1002183.
UNAIDS (2017). Overview - Indonesia. http://www.unaids.org/en/regionscountries/countries/indonesia. Accessed August 20, 2017.
WHO (2017). Data and Statistics. http://www.who.int/hiv/data/en/. Accessed August 20, 2017.
Yoshimura K. 2017. Current Status of HIV/AIDS in the ART Era. Journal of Infection and Chemotherapy, 23(1): 12-16.