XVIII International AIDS Conference


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Self-efficacy and perceived effectiveness of self-care symptom management strategies used by individuals with HIV and ART-related symptoms

I. Corless1, D. Wantland2, K. Kirksey3, J. Kempainnen4, L. Eller5, P. Nicholas1, W. Holzemer5, S. Human6, J. Arudo7, M. Rosa8, Y. Cuca9, S. Willard10, M.J. Hamilton11, C. Portillo9, E. Sefcik12, L. Robinson13, C. Bain14, S. Moezzi15, M. Maryland16, E. Huang14

1MGH Institute of Health Professions, School of Nursing, Boston, United States, 2Columbia University, New York, United States, 3SETON Family of Hospitals, Austin, United States, 4University of North Carolina at Wilmington, School of Nursing, Wilmington, United States, 5Rutgers University, School of Nursing, Newark, United States, 6University of South Africa, Pretoria, South Africa, 7Aga Khan University, Nairobi, Kenya, 8Universidad Autonoma De Santo Domingo, Gurabo, Puerto Rico, 9University of Califorinia at San Francisco, School of Nursing, San Francisco, United States, 10Elizabeth Glaser Pediatric AIDS Foundation, Washington, United States, 11Texas A&M University - Corpus Christi, School of Nursing, Corpus Christi, United States, 12Texas A&M University - Corpus Christi, Corpus Christi, United States, 13University of San Diego, San Diego, United States, 14University of Califorinia at San Francisco, San Francisco, United States, 15University of Utah, Salt Lake City, United States, 16City Colleges of Chicago, Chicago, United States

Background: General self-efficacy (GSE), the expectation “one can successfully perform a behavior” may differentiate those who successfully utilize self-care symptom management strategies (SCSMS). This sub-analysis (n=569) of an international, longitudinal RCT (n=775), investigates GSE as an important factor determining the type and frequency of SCSMS used and identifies differences in those with high- and low-GSE ratings and the influences on SCSMS selected.
Methods: Analysis using parametric- and non-parametric-repeated-measures tests for GSE and perceived effectiveness of SCSMS for anxiety, depression, diarrhea, fatigue, nausea, and neuropathy included grouping SCSMS for all six symptoms into five categories (below). The GSE scale was split above-(HSE) and below-(LSE) the median(Md=30). Symptom frequencies were assessed from the Symptom Checklist for HIV (SSC-HIV-rev.) and health- and medication-worry dimensions examined from the HIV/AIDS-Targeted Quality-of-Life scale (HAT-QoL). Demographics were also assessed.
Results: This 55%-male, 34%-female,11%-transgender-cohort used a series of SCSMS (exercise, thoughts/activities, complementary therapies, taking prescribed/OTC medications, and substance use). The HSE group used fewer substance-use strategies (F=2.245,p=0.025) and fewer medications strategies (F=-2.169, p=0.030). Thoughts/activities were tried by many participants with LSE-(p= 0.56, (CI=0.050-0.062). The HSE-group both taking ART-(ART-Y) and not-taking ART-(ART-N), reported better control over their health-(tART-Y =6.8, p≤0.001), (tART-N =3.8, p≤0.001); and fewer medication worries-(t ART-Y=4.6,p≤0.001). Three-month symptom report showed between-SE-group differences at baseline and time-2 -(F=6.7,p=0.01). Comparatively, the HSE-group reported fewer symptoms at baseline-(xLSE0=11.6/xHSE0=10.0-t=2.4,p=0.01), and stayed lower (xLSE2=9.6/xHSE2=8.0-t=2.3,p=0.02).
Conclusions: Higher-SE individuals reported fewer symptoms, initially and over time, and indicated improved overall health control, evidenced by QoL and adherence data, compared to the lower-SE group. This may explain why higher-SE group used fewer strategies, as strategies may be less effective or required; whereas the lower-SE group tried more strategies, including illicit-substance strategies, reporting higher effectiveness. These findings suggest that helping individuals to improve abilities in performing targeted efficacious behaviors may enhance SCSM use and QoL.

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