Abstract:
The introduction of highly active antiretroviral treatment to people living with Human Immunodeficiency Virus (HIV) has transformed the management of HIV from a fatal illness into a chronic health condition. However, research has shown formidable challenges exist adhering to highly active antiretroviral medications due to the near perfect adherence required to maintain therapeutic gain. One area that has been previously overlooked in the literature is whether illness perceptions or medication beliefs influence treatment adherence in people living with HIV. Alongside the transition of HIV into a chronic health condition is also interest in how people living with HIV manage their illness. Research shows health-related internet is being used by people living with HIV for health management, although the literature to date is conflicting as to how this use relates to outcomes, in particular to treatment adherence and the effect on the patient-practitioner relationship. Furthermore, research provides little insight into the psychosocial characteristics of health-related internet users. This study aimed to investigate the association between illness and medication beliefs on treatment adherence and health-related internet use. It also aimed to investigate the influence on health-related internet use on treatment adherence and the patient-practitioner relationship. To do this, a questionnaire was sent to all people living with HIV who had attended an outpatient appointment at the Auckland City Hospital Infectious Disease department in the past two years. Two hundred and eight people from 877 potential participants completed the questionnaire, which assessed treatment adherence, illness and medication beliefs, internet and social networking use, the patient-practitioner relationship, complementary and alternative therapy use, and symptoms. Data from a local pharmacy provided a participants number of HIV medication prescriptions filled in the 12-months prior to the study. Clinical data was also collected. Results showed participants who were nonadherent to their medications reported higher perceived sensitivity to medicines, more symptoms and greater consequences in living with HIV. Results also showed being younger, more highly educated, reporting lower satisfaction with the patient-practitioner relationship, and higher perceived sensitivity to medicines predicted health-related internet use. No relationship was found between health-related internet use and treatment adherence. Participants who reported health-related internet use also reported using information taken from the internet in consultations with their practitioners and in treatment decisions. This research suggests that beliefs are important factors to consider in the context of treatment adherence in people living with HIV. This study also illustrates the importance of health-related internet use for people living with HIV in the context of the patient-practitioner relationship and treatment decisions.