Description of a Framework to Enhance Antiretroviral Therapy Adherence using Self-efficacy and Belief about Medicines

There is ample evidence that strict adherence to antiretroviral therapy (ART) is strongly associated with optimal health outcomes among people living with HIV (PLWHA), although strict adherence to treatment regime is exceedingly difficult in chronic medical conditions. The intention to adhere to ART among PLWHA is often influenced by individual adherence self-efficacy, along with their Beliefs about Medicines. Various studies have described the factors influencing adherence in ART, and most of these were guided by conceptual framework encompassing the relevant constructs of the Cognitive-Behavioural theory (CBT), in which health behaviour is viewed as a result of an individual’s conscious rational choice. Based on the results of an empirical study conducted among a cohort of PLWHA and the findings from the literature, this paper describes a framework for enhancing adherence to ART using the Self-Efficacy model and Belief about Medicines theory. These two constructs from the CBT have been widely used in studying patients’ adherence to long-term therapy in chronic medical conditions. The identified interconnected system of beliefs associated with ART adherence are used in developing an algorithm which will prompt a healthcare professional to initiate need-based interventions that seeks to reduce personal beliefs that are negatively influencing the person’s adherence to ART.