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Open Access Research article

Medication adherence in HIV-positive patients with diabetes or hypertension: a focus group study

Anne K Monroe13*, Tashi L Rowe24, Richard D Moore15 and Geetanjali Chander16

Author Affiliations

1 Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

2 Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

3 Division of General Internal Medicine, 1830 E Monument St, Room 8060, 21287, Baltimore, MD, USA

4 Division of General Pediatrics and Adolescent Medicine, Research Program Coordinator, 200 N. Wolfe St, Suite 2096, 21287, Baltimore, MD, USA

5 Division of General Internal Medicine, 1830 E Monument St, Room 8059, Baltimore 21287 MD, USA

6 Division of General Internal Medicine, 1830 E Monument St, Room 8047A, Baltimore, MD 21287, USA

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BMC Health Services Research 2013, 13:488  doi:10.1186/1472-6963-13-488

Published: 25 November 2013

Abstract

Background

People with HIV are living longer with potent antiretroviral therapy (ART), and HIV is increasingly complicated by other chronic medical comorbidities. The objective of this study was to explore HIV-positive patients’ perspectives on living with HIV and diabetes mellitus (DM) or hypertension (HTN) and factors affecting medication adherence.

Methods

We conducted six focus groups. Two investigators independently coded transcripts for thematic content using editing style analysis. Codes were grouped into conceptual themes using consensus process.

Results

Thirty-five HIV-positive patients with diabetes or hypertension participated. Four major themes emerged: (1) Comorbidities are a source of concern and frustration, sometimes eclipsing concern regarding HIV (2) Understanding of health conditions and medications promotes adherence, (3) Simpler regimens with fewer side effects promote adherence, and (4) Untreated substance abuse and mental health issues hinder adherence.

Conclusions

HIV-positive patients in this study voiced concern regarding medical comorbidities and highlighted patient understanding, regimen factors, and substance abuse/mental health issues as barriers to adherence. Addressing these issues may improve outcomes in the aging HIV-positive population. Adherence to medications among HIV-positive patients with DM or HTN may be influenced by providing targeted disease-specific education, simplifying regimens, and treatment of substance abuse/mental health issues.

Keywords:
Diabetes; Hypertension; HIV; Adherence