Electronic Theses and Dissertations


Lisa L. Dale



Document Type


Degree Name

Doctor of Philosophy



Committee Chair

Joy Goldsmith

Committee Member

Linda Bennett

Committee Member

Gray Matthews

Committee Member

Cicely Wilson


Abstract While significant strides have developed evidence-based preventions and treatments for people living with HIV/AIDS (PLWHA), only 26% percent of HIV-positive people in care achieve the treatment objective of viral suppression (Viral Suppression, 2018). While the literature has identified a positive relationship between patient-provider communication and optimum treatment adherence, nonadherence is poorly understood, and no evidence-based model for such communication exists. This study aims to examine the perspectives of HIV-positive patients and family/friend caregivers (FFC) related to treatment adherence, as most of the literature has been dominated by the clinician’s point of view. Further, this work seeks to provide knowledge that will inform medication-taking behaviors so that future interventions can include patient-driven adherence discussions in treatment planning. This project employs a grounded theory approach to analyze HIV-positive patient and caregiver interviews about treatment. A convenience sampling method drew participants from an HIV support organization in Memphis, Tennessee. Results indicate that medication adherence demands collaborative communication between patients, caregivers, and providers that prioritizes the patient’s perspective. This communication approach requires the provider to respond to the patient’s concerns first to achieve positive medication-taking practices and quality of life. Adherence communication also allows the provider to perform a holistic assessment of the patients’/caregivers’ cognitive, emotional, behavioral, and environmental capacity to achieve treatment goals. Central to medication adherence is the discussion of supportive services. Keywords: HIV, medication adherence, patient-provider communication, caregiver


Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest


Open Access