Spirituality, Internalized Homonegativity, and Medication Adherence among Gay Men Living with HIV/AIDS

Examining Spiritual, Emotional and Physical Health Association in Self-Identified Gay Men Living With HIV/AIDS Anthony Peter Oltean, Ph.D. Jane Addams College of Social Work University of Illinois at Chicago Chicago, IL (2012) Dissertation Chairperson: Christopher Mitchell, Ph.D. The purpose of this study was to gain preliminary evidence to examine the utilization of spiritual coping to promote better adherence to HAART medication regimens for HIV+ gay men. To measure the key constructs in the study, The Daily Spirituality Experiences Scale (DSES) was used as the instrument for assessing the variable of spirituality. The variable of internalized homonegativity was measured using the Revised Nungesser Homosexuality Attitudes Inventory (RNHAI). For the dependant variable, both a short-term focused series of adherence questions, as well as a global 1-month recall rating task question-response were used to capture HAART medication adherence. This study sought to recruit participants through advertisements placed in a multitude of pharmacies and locations throughout the greater metro area of Chicago (as well as online advertisements via Facebook and Lifelube.org). All participants were provided access to the same advertisement design, which then directed them to the study’s URL address. Despite extensive recruitment efforts specifically targeting a self-identified gay and diverse sample, the respondents (n=227) to the survey were very homogeneous. The sample was predominately White/Caucasian, educated, and over the age of 40. Similarly, the HAART medication adherence results indicated a lack of variability. At the univariate level, measures of central tendency and dispersion were used to examine the distribution of the scores. At the bivariate level, Pearson’s r was used to examine the relationship between variables. Given the use of multiple items in the collection of medication adherence data, adherence indicators were developed based on an item-response analysis of the questions collectively. From this analysis a scale or index scale was generated from which to reference HAART Medication Adherence. At the multivariate level, logistic regression was used to examine the main effects of each independent variable on the dichotomous dependant variable(s). With respect to the research questions, no relationship between internalized homonegativity and spirituality, nor between spirituality and HAART medication adherence was observed. Only one statistically significant negative association was observed between the internalized homonegativity measure and the 1 Month Overall HAART medication adherence question. No other significant relationships between internalized homonegativity and HAART medication adherence were found. Logistic regression was used to determine if spirituality moderated the relationship of homonegativity and HAART medication adherence. There was no significant moderating effect of spirituality in this sample. Thus, spirituality did not moderate the relationship between homonegativity and HAART medication adherence.