The role of anger in adherence to highly active antiretroviral treatment in patients infected with HIV.

BACKGROUND

Adherence to highly active antiretroviral treatment (HAART) is critical to long-term treatment success in patients infected with human immunodeficiency virus (HIV). However, the relationship between psychological variables and medication adherence is still poorly understood. The aim of this study was to investigate how anger dimensions in subjects with HIV affect adherence to antiretroviral drugs.

METHODS

One hundred and thirty outpatients with HIV who were nondepressed and receiving HAART were administered the State-Trait Anger Inventory and a compliance self-report questionnaire. They also underwent clinical laboratory tests aimed at investigating immune function and disease stage.

RESULTS

Forty-three patients (33%) reported suboptimal adherence. Full compliance with HAART was related to higher age, lower HIV RNA level, lower trait anger, lower outside-directed anger and greater anger control. In a multiple regression analysis, low trait anger (p = 0.02) and high anger control (p = 0.03) were significantly associated with full adherence to HAART.

CONCLUSIONS

Anger dimensions are linked with, and may affect, adherence to HAART. A better understanding of the psychological determinants of compliance might allow for the identification of patients who are at higher risk of nonadherence. To sustain adherence to HAART, these patients may benefit from increased clinical attention or intervention.