The impact of stigma on medication adherence among HIV-positive adolescent and young adult females and the moderating effects of coping and satisfaction with health care

To explore whether HIV stigma negatively impacts adherence to antiviral medications in HIV-infected adolescent women, moderational analysis was conducted and factors identified that could alter said relationship. Study participants were 178 adolescent females age 15-24, enrolled between 2003-2005, from 5 different cities and 60 provided adherence information. Findings reported by this cohort of 60 adolescent women included: medication adherence, 64.3% reporting adherence at baseline and 45.0% at 12 months; HIV stigma score of 57.60 (standard deviation [SD], 11.83; range, 25-86). HIV stigma was not found to be a significant predictor when binary logit regression was run with medication adherence at 1 year. Using moderational analysis, factors that could moderate stigma's effect on medication adherence was still pursued and identified the following to be significant at 12 months: health care satisfaction (B=-0.020, standard error [SE]=0.010, p<.05); and Coping (proactive coping strategies [B=0.012, SE=0.005, p<.05]; turning to family [B=0.012, SE=0.016, p<0.05]; spiritual coping [B=0.021, SE=0.010, p<0.05]; professional help [B=0.021, SE=0.010, p<0.05]; physical diversions [B=0.016, SE=0.007, p<0.05]). Factors that had no significant moderating effects included: social support measures (mean=74.9; median=74.0) and depression score greater than 16=43%. We conclude that HIV-infected adolescent women experience HIV stigma and poor adherence over time. Factors like health care satisfaction and coping may minimize stigma's effect on medication adherence. Our findings are tempered by a small sample size and lack of a direct relationship between stigma and adherence on binary logit regression analysis.