The impact of life stress, coping style, and depressive symptomatology on HIV treatment adherence
Bottonari, Kathryn A.
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Individuals infected with the Human Immunodeficiency Virus (HIV) are living longer lives as a result of treatment with antiretroviral therapies (ART). Unfortunately, many HIV+ individuals have difficulty adhering adequately to their ART regimens. Considerable research has demonstrated that life stress negatively influences self-care behaviors, and it is therefore likely that life stress contributes to poor adherence to ART. This 3-month prospective investigation examined the impact of life stress (acute life events, chronic strain, and perceived stress) on adherence to HIV treatment regimens. However, past theory and research has suggested that life stress does not impact individuals uniformly and that the impact of stress on an individual's life is dependent on their method of coping with the stress. Likewise, depressive symptomatology has been identified as a barrier to adherence among HIV+ individuals. The present investigation sought to examine whether the relationship between life stress and treatment adherence is moderated by an individual's style of coping or depressive symptomatology. Results demonstrated that depression diagnosis moderated the relationship between life stress and treatment adherence. Specifically, acute life events predicted poorer treatment adherence among those individuals in a Major Depressive Episode, but not among non-depressed individuals. However, life stress did not predict treatment adherence as a main effect in the sample as a whole or interactively with coping style. Findings suggest that life stress has toxic effects for clinically depressed individuals and that treatment adherence interventions with depressed individuals may need to focus on stress management and reduction.