Attitude towards the disease as a risk marker of violation of adherence in HIV-infected patients

Objective. Assessment of the attitude towards the disease as a risk marker of violation of adherence to follow-up and treatment in HIV-infected patients.

Materials and methods. A total of 169 HIV-positive respondents were interviewed (women – 26.6%, median (Me) age 42 years, Me «experience» of living with HIV – 11 years). All respondents were taking ART, Me treatment duration was 8 years, Me CD4⁺ lymphocyte count was 679 cells/μl. 40.5% of respondents had experience of using psychoactive substances (including alcohol). The study used the «Type of Attitude Towards the Disease» questionnaire, which allows diagnosing 12 types of attitude towards the disease.

Results. 66.3% of respondents had a «pure» type of attitude to the disease, 26.1% had a mixed type, and 7.6% had a diffuse type. In the structure of the «pure» type, the anosognostic type prevailed - 63.5%, the share of ergopathic was 29.8%, and harmonious – 4.8%. No statistically significant gender differences in the prevailing types of attitude towards the disease were found. In the section on attitude to illness, respondents most often chose the statement «I try not to think about my illness and live a carefree life» – 62.1%. In the section on attitude to treatment – «I would be ready for the most painful and even dangerous treatment, just to get rid of the disease» – 19.8%, in the section on attitude to doctors and medical staff – «I have great respect for the medical profession» – 73.8%. Analysis of the sections of the questionnaire ignored by respondents and, accordingly, dropped out of the analysis showed that most often they concerned attitudes to treatment, with family and friends, and loneliness. Clinical cases of attitude to illness that negatively affected compliance with doctor’s recommendations are presented.

Conclusion. Identification of anosognosic and ergopathic types of attitude to illness helps to predict the occurrence of situations that are risky in relation to compliance with doctor’s recommendations, and also allows to increase the effectiveness of counseling, using an individual approach depending on the type of attitude to illness.