Taking medications religiously: Assessing baseline religious practices and beliefs to predict HAART adherence among HIV-infected persons

BACKGROUND: The efficacy of highly active antiretroviral therapy (HAART) is dependent upon moderately high levels of adherence; however, predicting adherence before HAART initiation can be difficult. METHODS: We conducted a prospective, longitudinal study among 350 HIV-infected adults attending a large HIV clinic in San Diego, CA from January 1, 2010 to December 31, 2011 to examine both established and novel predictors of adherence, including specific religious practices and beliefs. Statistically significant (p<0.05) variables identified in univariate analyses were included in subsequent multivariate analyses predicting 100% adherence at 3 and 6 months. RESULTS: Higher annual household income and HAART experience were predictive of greater adherence at 3 months; religious affiliation and CDC stage A/B were predictive of greater adherence at 6 months. Participants who said their beliefs increased their acceptance/tolerance of others, helped them feel they were not alone, made them feel they had a connection with a higher being, were influential during their recovery, and helped them feel compassion/love/respect for others were more likely to be 100% adherent. Conversely, participants who believed God would answer their prayers for a recovery and those who regularly attended religious services, participated in religious rituals, and prayed and meditated to get in touch with God were less likely to be 100% adherent. CONCLUSION: Results indicate that a patient's religious beliefs and practices may predict subsequent medication adherence. Interventions should be designed to emphasize the use of positive religious coping strategies and address the adverse implications of religious fatalism.