Adherence Self-Management and the Influence of Contextual Factors Among Emerging Adults With Human Immunodeficiency Virus.
Ann-Margaret Dunn Navarra, Robin Whittemore, Suzanne Bakken and 7 others
PMID 31972851WHAT IT FOUND
Young adults with HIV said stigma, disclosure fears, and wanting to feel normal were linked to hiding or missing HIV medicines.
Support from peers and clinic staff mattered, while alarms reminded them of infection.
Key findings
01Participants reported that stigma, disclosure fears, and wanting to feel normal led them to hide HIV medicines or miss doses in social settings.
02Support from other people living with HIV and from healthcare staff was described as important for adherence, while lack of peer support contributed to isolation and high-risk behavior.
03Mental health challenges, including depression, trauma, abuse, and substance use, were reported as contributors to missed doses and risk-taking behavior.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small, convenience-based, English-speaking, and mostly perinatally infected, so it may not represent other HIV-positive youth. Each person was interviewed only once, so the study did not track how stigma, support, or mental health changed over time. HIV disease stage and medication regimen complexity were not explored, although they can affect adherence. The study did not test ACCESS or any intervention, so it cannot show whether peer-led mobile health support improves adherence. Findings are themes from 20 interviews, not measured effects, and should not be generalized to all emerging adults with HIV.
Declared interests
The authors reported no conflicts of interest. The study was supported by NIH extramural research funding.
The easy way to misread this
Do not read these themes as proof that stigma causes missed doses or that peer-led mobile health support improves adherence. The study interviewed 20 people once and did not test any treatment.