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Poor Self-efficacy for Healthcare Provider Interactions Among Individuals with HIV-Associated Neurocognitive Disorders

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Abstract

Two factors that influence HIV health behaviors and therefore may contribute to gaps in the HIV treatment continuum are poor health-related self-efficacy and HIV-associated neurocognitive disorders (HAND). However, the relationship between HAND and self-efficacy has not been assessed. In an HIV sample, 91 individuals with intact cognition (HAND−) and 40 individuals with HAND (HAND+) were administered a measure of self-efficacy for healthcare interactions with providers. Participants with HAND had significantly lower scores on this measure, which were correlated with poorer episodic and semantic memory performance, as well as self-reported memory symptoms in daily life. Findings suggest that neurocognitive impairment, and particularly memory dysfunction, may play an important role in self-efficacy for healthcare interactions in HIV. Further examination of the interplay between HAND and self-efficacy is warranted as these two factors may be important for the public health goal of identifying targets for improving access, delivery, and maintenance of HIV care.

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Acknowledgements

Funding was provided by National Institute of Mental Health (Grant Nos. 1-R01MH073419, P30MH62512), National Institute on Drug Abuse (Grant No. 1T32DA031098). The HIV Neurobehavioral Research Program (HNRP) group is affiliated with the University of California, San Diego, and the Veterans Affairs San Diego Healthcare System, and includes Director: Igor Grant, M.D., Ph.D.; Co-Director: Robert K. Heaton, Ph.D.; Associate Directors: J. Hampton Atkinson, M.D., Ronald J. Ellis, M.D., Ph.D., and Scott Letendre, M.D.; Center Manager: Thomas D. Marcotte, Ph.D., Jennifer Marquie-Beck, M.P.H., Donald R. Franklin, Jr., Melanie Sherman; Neuromedical Component: Ronald J. Ellis, M.D., Ph.D. (co-P.I.), Scott Letendre, M.D. (co-P.I.), J. Allen McCutchan, M.D., Brookie Best, Pharm.D., Rachel Schrier, Ph.D., Debra Rosario, M.P.H.; Neurobehavioral Component: Robert K. Heaton, Ph.D. (P.I.), J. Hampton Atkinson, M.D., Thomas D. Marcotte, Ph.D., Mariana Cherner, Ph.D., David J. Moore, Ph.D., Erin Morgan, Ph.D., Matthew Dawson; Neuroimaging Component: Christine Fennema-Notestine, Ph.D. (P.I.), John Hesselink, M.D., Sarah L. Archibald, M.A., Gregory Brown, Ph.D.; Neurobiology Component: Cristian Achim, M.D., Ph.D.; Neurovirology Component: David M. Smith, M.D. (P.I.), Sara Gianella, M.D., Douglas Richman, M.D.; Neuroscience and Animal Models (NAM) Component: Cristian L. Achim, M.D., Ph.D. (Core Director), Marcus Kaul, Ph.D., Virawudh Soontornniyomkij, M.D.; International Component: J. Allen McCutchan, M.D., (P.I.), Mariana Cherner, Ph.D.; Developmental & Pilot Component: Scott Letendre, M.D., Mariana Cherner, Ph.D.; Participant Accrual and Retention Component: J. Hampton Atkinson, M.D. (P.I.), Jennifer Marquie-Beck, M.P.H.; Data Management and Information Systems Component: Lucila Ohno-Machado, Ph.D. (P.I.), Clint Cushman; Statistics Component: Ian Abramson, Ph.D. (P.I.), Florin Vaida, Ph.D. (Co-PI), Anya Umlauf, M.S. Bin Tang, M.S.

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Authors and Affiliations

  1. Department of Psychiatry, University of California, San Diego, San Diego, CA, USA

    Erin E. Morgan, Steven Paul Woods, Jennifer E. Iudicello, Igor Grant & Javier Villalobos

  2. Department of Psychology, University of Houston, Houston, TX, USA

    Steven Paul Woods

  3. Department of Psychiatry (8231), University of California, San Diego, 220 Dickinson St., Suite B, San Diego, CA, 92103, USA

    Erin E. Morgan

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  1. Erin E. Morgan
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  2. Steven Paul Woods
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  3. Jennifer E. Iudicello
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Consortia

The HIV Neurobehavioral Research Program (HNRP) Group

  • Robert K. Heaton
  • , J. Hampton Atkinson
  • , Ronald J. Ellis
  • , Scott Letendre
  • , Thomas D. Marcotte
  • , Jennifer Marquie-Beck
  • , Donald R. Franklin
  • , Melanie Sherman
  • , J. Allen McCutchan
  • , Brookie Best
  • , Rachel Schrier
  • , Debra Rosario
  • , Mariana Cherner
  • , David J. Moore
  • , Erin Morgan
  • , Matthew Dawson
  • , Christine Fennema-Notestine
  • , John Hesselink
  • , Sarah L. Archibald
  • , Gregory Brown
  • , Cristian Achim
  • , David M. Smith
  • , Sara Gianella
  • , Douglas Richman
  • , Cristian L. Achim
  • , Marcus Kaul
  • , Virawudh Soontornniyomkij
  • , Lucila Ohno-Machado
  • , Clint Cushman
  • , Ian Abramson
  • , Florin Vaida
  • , Anya Umlauf
  •  & Bin Tang

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Correspondence to Erin E. Morgan.

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Erin E. Morgan, Steven Paul Woods, Jennifer E. Iudicello, Igor Grant, Javier Villalobos, and members of the HIV Neurobehavioral Research Program (HNRP) Group declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Morgan, E.E., Woods, S.P., Iudicello, J.E. et al. Poor Self-efficacy for Healthcare Provider Interactions Among Individuals with HIV-Associated Neurocognitive Disorders. J Clin Psychol Med Settings 26, 13–24 (2019). https://doi.org/10.1007/s10880-018-9560-0

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