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. 2019 May;23(5):1297-1305.
doi: 10.1007/s10461-018-2278-z.

Non-planning Impulsivity But Not Behavioral Impulsivity is Associated with HIV Medication Non-adherence

Eugene M Dunne  1   2 , Robert L Cook  3 , Nicole Ennis  4
Affiliations

Non-planning Impulsivity But Not Behavioral Impulsivity is Associated with HIV Medication Non-adherence

Eugene M Dunne et al. AIDS Behav. 2019 May.

Abstract
in English, Spanish

Despite advances in HIV antiretroviral medications, some patients do not achieve adequate medication adherence or suppressed viral load. The aim of this study was to identify the relationship between factors of impulsivity and medication non-adherence. It was hypothesized that impulsivity would have a direct association with non-adherence, after accounting for other known correlates. Participants included 322 HIV positive individuals (M age = 49, 56% male, 64% Black/African American). Impulsivity was measured using the Barratt Impulsiveness Scale-Brief (BIS-Brief). Factor analysis was conducted to determine if BIS-Brief resulted in a unidimensional or multi-factor solution. Results were suggestive of a two-factor solution: behavioral impulsivity and non-planning impulsivity. Structural equation modeling found non-planning impulsivity was associated with non-adherence (β = 0.18, p = 0.016), while no significant association was observed for behavioral impulsiveness. Results suggest that strategies related to planning for future consequences may be beneficial for impulsive persons with medication adherence difficulties.

A pesar de los avances en los medicamentos antirretrovirales contra el VIH, algunos no logran una adherencia adecuada a los medicamentos ni suprimen la carga viral. El objetivo de este estudio fue identificar la relación entre los factores de impulsividad y la adherencia a la medicación. Se formuló la hipótesis de que la impulsividad tendría una asociación directa con la falta de adherencia, después de tener en cuenta otros correlativos conocidos. Los participantes incluyeron 322 individuos VIH positivos (M edad = 49, 56% hombres, 64% Black/African American). La impulsividad se midió usando la Barratt Impulsiveness Scale-Brief (BIS-Brief). El análisis factorial se realizó para determinar si BIS-Brief dio como resultado una solución unidimensional o multifactorial. Los resultados sugirieron una solución de dos factores: impulsividad conductual e impulsividad no planificada. El modelado de ecuaciones estructurales encontró que la impulsividad no planificada se asoció negativamente con la adherencia (β = 0.18, p = 0.02), mientras que no se observó una asociación significativa para la impulsividad conductual. Los resultados sugieren que las estrategias relacionadas con la planificación de las consecuencias futuras pueden ser beneficiosas para las personas impulsivas con dificultades de adherencia.

Keywords: Antiretroviral therapy; HIV; Impulsivity; Medication adherence.

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Conflict of interest statement

Conflict of interest

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Factor structure for Barratt Impulsiveness Scale-Brief in an HIV sample. Note Initial scale analysis (Model a) suggested poor fit, with several factor loadings < 0.40; Corrected structure (Model b) based on the two factor solution identified in PCA resulted in adequate fit. Model a CMIN/DF = 13.80, TLI = 0.20, IFI = 0.57, CFI = 0.56, RMSEA = 0.20, Model b CMIN/DF = 1.77, TLI = 0.95, IFI = 0.98, CFI = 0.97, RMSEA = 0.049
Fig. 2
Fig. 2
Complete model predicting non-adherence with AMOS software. Note Regression (β) paths indicated by solid lines; correlation (r) paths indicated by broken lines. Model fit statistics: CMIN/DF = 1.70, TLI = 0.92, IFI = 0.95, CFI = 0.95, RMSEA = 0.047
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. HIV incidence: estimated annual infections in the U.S., 2008–2014 CDC Fact Sheets. 2015.
    1. Ray M, Logan R, Sterne J, et al. The effect of combined antiretroviral therapy on the overall mortality of HIV-infected individuals. AIDS. 2010;24(1):123. - PMC - PubMed
    1. Kyser M, Buchacz K, Bush TJ, et al. Factors associated with non-adherence to antiretroviral therapy in the SUN study. AIDS Care. 2011;23:601–11. - PubMed
    1. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505. - PMC - PubMed
    1. Cook R, Zhou Z, Kelso-Chichetto N, et al. Alcohol consumption patterns and HIV viral suppression among persons receiving HIV care in Florida: an observational study. Addict Sci Clin Pract. 2017;12:22. - PMC - PubMed