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Citation Award MNRS Abstract: Perspectives of HIV-Infected Women Who Have Significant Adherence Difficulties

Medication adherence is vital to the success of highly active antiretroviral therapy (HAART), which has been shown to suppress viral replication and slow disease progression. A very high level of adherence to the medication regimen is necessary to get the full benefit from HAART, yet about half of the people on HAART do not take the medications as prescribed. The purpose is to explore personal and contextual factors that influence HIV-infected women’s capacity to initiate and adhere to treatment regimens. A Feminist Narrative conceptual framework was used. The setting for this National Institutes of Health–funded qualitative study (#R01NR04840) was both urban and rural areas across the state of Wisconsin. Women were recruited using targeted chain referral sampling. The sample for this presentation was 14 women who had difficulty with HIV medication adherence and who participated in a larger longitudinal qualitative study of 55 racially and culturally diverse women with HIV. The design of the study was a repeated narrative interview design in which up to 10 semistructured interviews were conducted with each woman over a 2-year period. The instruments were baseline and prospective interview guides used to encourage women to tell their stories and describe their experiences as women who were HIV-positive. Interviews lasting approximately 2 hours were conducted. Interviews were transcribed verbatim and entered into N-VIVO, a software program, to facilitate management and coding of these data. The coded interviews were analyzed using multistage narrative analysis. The findings suggest issues of nonadherence, perceptions that the side effects of the medication are indicators of serious harm being caused to the self, limited health literacy, weak relationships with providers, and inexperience with daily routines. The findings are relevant for assisting nurses to understand and effectively support women in managing the often difficult and uncomfortable HIV medication regimens. Western Journal of Nursing Research Volume 30 Number 1 February 2008 149 © 2008 Sage Publications 10.1177/0193945907308663 http://wjn.sagepub.com hosted at http://online.sagepub.com