ACCEPTANCE AND ADHERENCE WITH ANTIRETROVIRAL THERAPY AMONG HIV-INFECTED WOMEN IN A CORRECTIONAL FACILITY

We examined attitudinal and demographic col-relates of antiretroviral acceptance and adherence among incarcerated HIV-infected women. Struct ured interviews were conducted with 102 HIV-infected female prisoners eligible for antiretroviral therapy. Three quarters of the women were currently taking antiretroviral agents, of whom 62% were adherent to t herapy. Satisfaction was very high with the HIV care offered at the pr ison; 67% had been first offered antiretroviral agents while in prison . Univariate and multivariate analyses showed acceptance of the first offer of antiretroviral therapy to be associated with trust in medicat ion safety, lower educational level, and non-black race. Current accep tance of therapy was associated with trust in the medication's efficac y and safety. Medication adherence was correlated with the Patient-phy sician relationship and presence of emotional supports. Nearly one hal f of these HIV-seropositive women were willing to take experimental HI V medications in prison. This was correlated with satisfaction with ex isting health care, the presence of HIV-related social supports, and p erceived susceptibility to a worsening condition. Acceptance and adher ence with antiretroviral agents appear to be significantly associated with trust in medications, trust in the health care system, and interp ersonal relationships with physicians and peers. Development of models of care that encourage and support such relationships is essential fo r improving adherence to antiretroviral therapy, especially for popula tions that have historically been marginalized from mainstream medical care systems.