HAART has meant a longer, healthier life with many people becoming increasingly optimistic about their future. Something to be thankful for? Not according to researchers at the University of Pennsylvania.
In an article published in the September edition of the Journal of General Internal Medicine investigators report that well educated people doing well on HAART are much more likely to have unprotected sex and forget to take their medication properly.
Questionnaires were mailed to 295 HIV-positive people attending a specialist treatment centre. The questionnaire asked about experience with HIV from the time of diagnosis to the present, and also asked people to assess their current life expectancy. People were also asked to report their level of adherence to their HAART regimen and the frequency with which they had unprotected sex.
Over 75% of people (220) returned their questionnaires. Nearly two thirds were non-white, gay or bisexual men. Half the sample had had at least 12 years of education, however the majority of the sample was living in poverty, with an income of less than $10,000 a year.
Most people were optimistic about their life expectancy, with 27% saying that they expected to live to old age. The most optimistic were non-whites with 12 or more years of education and a CD4 count of 200 cells/mm3 or above.
When self-reported incidences of non-adherence or unprotected sex were analysed, the investigators found that 26% of optimists, but only 13% of pessimists reported unprotected sex, and that 57% of optimists reported not always taking their HAART against 29% of pessimists.
Noting the findings with concern, the investigators concluded that HIV treatment centres should pay more attention to their patients' prognostic beliefs and the behaviour this may entail.
Holmes WC et al. HIV-seropositive individuals optimistic beliefs about prognosis and relation to medication and safe sex adherence. Journal of General Internal Medicine 17: 9, 677 – 683, 2002.