Antiretroviral adherence in persons with HIV/AIDS and severe mental illness.

This study identified factors impacting adherence to human immunodeficiency virus (HIV) therapies in a sample of 46 persons diagnosed with HIV/acquired immune deficiency syndrome and severe mental illness who were receiving care through a day care program in Northern California. Comprehensive descriptions of factors and circumstances that influence adherence behaviors were obtained through critical incident interviews, and a taxonomy of adherence factors was determined. A chi2 analysis that examined differences between patient characteristics and major adherence factors found that planning was more likely to be reported by older persons taking HIV medications over longer periods. Nonwhite persons and those living alone were more apt to rely on the use of reminders and cues. Persons with bipolar disorder reported substantially more incidents of the impact of their symptoms on adherence to HIV therapies than persons with other psychiatric diagnoses. The taxonomy of adherence factors provides important information for developing relevant adherence education programs and an essential foundation for testing compliance interventions.