Nannis E, Temoshok L, Jenkins RA, Rundell JR, Brown GR, Patterson TL; International Conference on AIDS.

Int Conf AIDS. 1992 Jul 19-24; 8: 111 (abstract no. PuB 7377).

HMJ Foundation, Rockville, MD.

OBJECTIVE: To determine how expectations, coping styles, and experience with various treatments for HIV relate to decisions to discontinue or alter prescribed dosage of zidovudine (AZT), specifically, and cooperation with treatment and clinical trials, more generally. METHOD: As part of a larger study of biopsychosocial factors related to HIV progression, 150 HIV infected U.S. military medical beneficiaries completed a self report questionnaire concerning perceptions and experiences with AZT and a standardized battery measuring affect, social support and coping. Patients were seen in 3 tri-service military medical centers. The sample was young (median age = 33), ethnically diverse (56% white, 35% black, 9% other), and included men (95%) and women (5%). The sample was comprised of primarily asymptomatic individuals with a median CD4+ count of 250. RESULTS: Preliminary analyses (N = 84) indicated that patients who were at a later stage of the disease, who reported more negative than positive expectations of AZT, who felt more depressed, and who experienced more side effects, were significantly more likely to alter their prescribed doses. Patients who reported more severe side effects and fewer positive expectations about AZT, and who expressed greater hostility and felt pressured into taking AZT, were significantly more likely to discontinue their AZT. Those who identified with a "stoic" coping style also were more likely to discontinue their AZT, while those who identified with a style characterized by assertiveness and information-seeking were significantly more likely to alter their prescribed dose. There were no significant associations among demographic variables and altering or discontinuing dosage. Additional analyses will focus on how expectations and perceived positive and negative changes resulting from taking AZT relate to self reported coping styles. DISCUSSION AND CONCLUSIONS: Expectations, affect, and coping styles relate to self reported noncompliance with AZT. Those who felt pressured into taking the drug (primarily by their physicians) were significantly more likely to discontinue their treatments. It is likely that these results would generalize to other treatments and to participation in clinical trials. Being able to identify factors that relate to noncompliance with treatment or clinical trials will be critical both for patient well-being and for the integrity of clinical trials research.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Adaptation, Psychological
• Clinical Trials as Topic
• Female
• HIV Infections
• HIV Seropositivity
• Health Behavior
• Humans
• Male
• Questionnaires
• Self Concept
• Social Support
• United States
• Zidovudine
• psychology
• therapy

Other ID:

• 92403427

UI: 102201141

From Meeting Abstracts