Zidovudine adherence among individuals with HIV infection.

The objective was to investigate the relationships among health beliefs, attitudes, and zidovudine compliance in individuals with HIV infection. A survey was administered to 52 individuals with HIV infection. The survey items, which reflected concerns expressed about zidovudine, were generated based on barriers to and benefits of zidovudine and the perceived susceptibility to and perceived severity of HIV as described by the health belief model (HBM). These items were expressed as attitudes and beliefs. Items were subjected to factor analysis, and survey results were correlated with laboratory data to predict adherence to their prescribed medication-taking regimen. Data indicated that 42.3% of the subjects were compliant with zidovudine. Factor analysis identified four dimensions: problems taking and scepticism about zidovudine; degree of concern about HIV; perceived severity of HIV; and physical barriers to taking zidovudine. Logistic regression analysis (forward conditional entry) identified those who were having problems taking zidovudine and who were sceptical about its effectiveness, and ethnicity as significant independent predictors of compliance, correctly classifying 75% of cases (p < 0.01). The fact that subjects who have problems taking zidovudine or are sceptical about the value of zidovudine are less compliant, and that this dimension is a significant predictor of compliance, suggests that non-compliance is related to attitudes and beliefs about zidovudine. This is consistent with the HBM, which holds that the balance between barriers and benefits of a health-related behaviour are significant determinants of outcome.