Title

The relationship of physician trust and statin adherence to age and HIV/AIDS status in older persons living with HIV/AIDS and cardiovascular disease: A secondary data analysis from the Veterans Aging Cohort Study

Date of Completion

January 2012

Keywords

Gerontology|Health Sciences, Aging|Health Sciences, Medicine and Surgery

Degree

Ph.D.

Abstract

For older people living with the human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS), adherence to highly active antiretroviral therapy (HAART) is of primary importance. Yet, in the United States, older people living with HIV/AIDS (PLHA) may be affected simultaneously by HIV/AIDS and any number of other chronic health conditions for which treatment with one or more medications is recommended. In this way, HIV/AIDS becomes a co-morbid condition as the focus of treatment includes another, chronic health condition. Of specific interest is the group of chronic health conditions collectively known as cardiovascular disease (CVD), for which treatment with the statin medications ("statins") is appropriate. Over time and with the process of aging, older people living with HIV/AIDS and CVD (PLHA/CVD) access the healthcare system in order to obtain statins and other medications. The degree to which older PLHA/CVD trust their physicians may influence adherence to statins prescribed for treatment of CVD. By examining (a) one population, (b) one medication and (c) one issue pertaining to adherence to said medication, this research aims to illustrate the importance of trust on adherence. Here, the influence of trust in physicians and subsequent adherence to statins are examined with regard to older PLHA/CVD by means of the Veterans Aging Cohort Study (VACS). VACS participants (N = 6467) are matched according to age, ethnicity/race, and site comparators (Justice et al., 2006). Of 6,467 participants, a smaller sample of older veterans with CVD (n = 2704) is utilized. The Andersen and Newman Behavioral Model of Health Service Use as well as ideas pertaining to contextualism and life course human development serve as a conceptual framework in which to discuss this research. Results suggest that age significantly influences trust in physicians; not only do older veterans demonstrate greater levels of adherence to statins, but older veterans also possess higher levels of trust in their physicians. Results from bivariate regression analyses of trust on adherence, however, are not statistically significant and suggest the need for a more thorough examination of measures of trust. ^