The Need for Sociocultural Awareness to Maximize Treatment Acceptance and Adherence in Individuals Initiating HIV Therapy

Despite major advances in the long-term treatment of patients with HIV infection, there still exist sociocultural barriers to care. This article will focus on recognizing and understanding the cultural factors that affect treatment in patients starting antiretroviral therapy, most important the factors that can contribute to poor, as well as favorable, treatment adherence in diverse individuals. These factors include cultural and religious stigma; domestic violence; socioeconomic constraints, including literacy, living conditions, presence or absence of family, and social support networks; psychiatric disorders; and pregnancy. The authors also discuss ways in which clinicians can prepare patients for treatment initiation and improve their ongoing adherence by incorporating knowledge of these sociocultural differences into and modifying plans for patient care accordingly.