RESEARCH ARTICLE


Influence of the First Consultation on Adherence to Antiretroviral Therapy for HIV-infected Patients



Marion Peyre1, 2, Aurélie Gauchet2, 3, Matthieu Roustit2, 4, 5, Pascale Leclercq1, Olivier Epaulard1, 2, 6, *
1 Service des Maladies Infectieuses, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
2 Université Grenoble Alpes, Grenoble, France
3 Laboratoire Inter-Universitaire de Psychologie - Personnalité, Cognition, Changement Social (LIP/PC2S) EA 4145, Université Grenoble Alpes, Grenoble, France
4 Pharmacologie Clinique - CIC1406, Pôle Recherche, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
5 Inserm, HP2, 38000 Grenoble, France
6 Team “HIV and other human persistent viruses”, Institut de Biologie Structurale, UMR 5075 UGA-CEA-CNRS, Grenoble, France


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© Peyre et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Service des Maladies Infectieuses, CHU de Grenoble, CS10217, 38043 Grenoble cedex 09, France; Tel/Fax: 0033 4 76 76 52 91; E-mail: OEpaulard@chu-grenoble.fr


Abstract

Background:

Physician attitude influences the way patients cope with diagnosis and therapy in chronic severe diseases such as cancer. Previous studies showed that such an effect exists in HIV care; it is likely that it begins with the first contact with a physician.

Objective:

We aimed to explore in HIV-infected persons their perception of the first consultation they had with an HIV specialist (PFC-H), and whether this perception correlates with adherence to antiretroviral therapy.

Method:

The study was conducted in Grenoble University Hospital, France, a tertiary care center. Every antiretroviral-experienced patient was asked to freely complete a self-reported, anonymous questionnaire concerning retrospective PFC-H, present adherence (Morisky scale), and present perceptions and beliefs about medicine (BMQ scale).

Results:

One hundred and fifty-one questionnaires were available for evaluation. PFC-H score and adherence were correlated, independently from age, gender, and numbers of pill(s) and of pill intake(s) per day. BMQ score also correlated with adherence; structural equation analysis suggested that the effect of PFC-H on adherence is mediated by positive beliefs.

Conclusion:

These results suggest that for HIV-infected persons, the perceptions remaining from the first consultation with an HIV specialist physician influence important issues such as adherence and perception about medicine. Physicians must be aware of this potentially long-lasting effect.

Keywords: Adherence, Antiretroviral, Beliefs about medicine, Consultation, Morisky, Patient perceptions.