Cultural and neuropsychological predictors of medication adherence

Reuben N Robbins, Fordham University


HIV infection among the Hispanic community is disproportionate to the overall population of the United States. Hispanics account for 13% of the U.S. population, yet they account for 20% of reported AIDS cases in the U.S. Numerous studies have identified the detrimental neurocognitive sequela and functional impact of HIV infection, and research has shown that ethnic minorities are less likely to adhere to medical protocols. Highly active antiretroviral therapy (HAART) for HIV/AIDS has helped to inhibit the detrimental neurocognitive effects of HIV's involvement in the central nervous system. However, in order to benefit from HAART, individuals must be near perfect in their compliance. Studies have shown that individuals with neuropsychological (NP) impairment are less likely to adhere to their medication regimens. However, these studies have examined mostly African American populations, with no emphasis on cultural differences. With disproportionate rates of HIV infection among Hispanics, the high rate of new infections among Hispanics, and the risk of not adhering to medical protocols, this group is at particularly high risk for neurocognitive impairment and impaired functioning in everyday activities. The present study examined the role NP and cultural factors play in HAART adherence in a sample of HIV+ Hispanic and non-Hispanic white adults. Methods. Forty-two HIV+ participants (28 Hispanic and 14 non-Hispanic white) were recruited. All participants underwent neuromedical and psychiatric screening, as well as s comprehensive NP evaluations. In addition, participants were administered a 30-day self-report questionnaire of HAART adherence. Hispanic participants also completed an acculturation measure. Results. Mean adherence rate for Hispanics was significantly lower than 95% and the non-Hispanic white mean adherence rate. Global NP functioning was positively correlated with adherence rate among all participants, as were the NP domains of memory and motor functioning. No association between acculturation and adherence was found. Conclusion. The current indicated that HIV+ Hispanics have poorer adherence compared to non-Hispanic whites and significantly lower adherence than the recommended 95%. Additionally, NP functioning is also related to adherence among HIV+ Hispanics and non-Hispanic whites.

Subject Area

Clinical psychology|Hispanic American studies

Recommended Citation

Robbins, Reuben N, "Cultural and neuropsychological predictors of medication adherence" (2008). ETD Collection for Fordham University. AAI3337631.