Lipodystrophy-associated manifestations such as body fat changes, and increases in glucose and lipid levels remain a challenge for HIV-infected persons and their providers. Given that side effects of medications, as well as symptomatic HIV disease have been implicated in non-adherence, the implications of lipodystrophy for adherence are a concern. Objective: This study was designed to determine the relationship between time of initial diagnosis, presence of lipodystrophic symptomatology, and adherence to medication regimens in persons with HIV/AIDS. Design: Cross-sectional, descriptive design. Population, Sample, Setting: The sample consisted of 165 persons from three outpatient HIV clinics in Boston MA, Fresno CA, and Victoria TX. Variables: This paper examined the relationship between lipodystrophic symptoms seen in HIV/AIDS and adherence to antiretroviral medications. Methods: Participants were asked to complete open-ended questions regarding presence and types of lipodystrophy-associated symptoms, self-reported management of body fat alterations, and how these physical changes made them feel. Adherence was measured using the Morisky Medication Adherence Scale (MMAS). Findings: On a Likert-type scale ranging from 0-4, with “0” indicating “very adherent” and “4” indicating “non-adherent,” the mean score on the MMAS was 1.44 (SD + 1.34). This finding demonstrated that the participants consistently took their medications despite self-reports of significant numbers of HIV disease and treatment-related body fat changes. However, there was a negative correlation between medication adherence and years of HIV positive status. Conclusions: These findings are somewhat in contrast to what is widely reported in the scientific literature. Subjects in this study did report a high level of adherence to medication regimens despite the purported association with lipodystrophy. Length of time since initial diagnosis with HIV, however, had a negative impact on medication adherence. Implications: Further research is required to examine adherence over time. Prospective studies that evaluate symptoms and adherence issues in HIV-infected persons are also warranted.
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