In the precontemplation stage, patients feel that ART is not http://www.selleckchem.com/products/Belinostat.html appropriate for them at this certain point. In the contemplation stage, they weigh the benefits and risks of ART. In the preparation stage, patients have decided to start ART, in the action and maintenance stage they start taking ART and are committed to adhere to it, and in the relapse stage, patients start to reassess motivation and barriers to treatment. Thus, whether patients attribute their symptoms to HIV or ART may affect their readiness to adhere to ART. For example, individuals suffering from severe neuropathic pain and attributing this pain to HIV have a strong incentive to take ART, whereas attributing the same pain to ART may lead to the contrary.

According to the Necessity Concerns Framework [7], attribution of symptoms to HIV may enhance perceived necessity to take and adhere to ART, whereas attributions of symptoms to ART raises concerns about taking ART and is a predictor of intentional non-adherence. The purpose of the present study was to examine causal symptom attributions among women and men with HIV, either to HIV or to ART, and to analyze a potential impact on their treatment decisions. Although the distinction between patients’ attributions of symptoms to HIV or ART may be a determinant of treatment motivation and success, symptom-checklists commonly combine HIV-related and ART-related symptoms in one category [8]. To our knowledge, there are few studies in predominantly male populations examining causal attributions of symptoms. The study of Johnson et al.

[9] (88% men) demonstrated that patients taking ART made a distinction between HIV-related and ART-related symptoms. However, this study did not examine if this distinction had any impact on treatment decisions. Several qualitative studies describe that most people with HIV suffering from fatigue attribute this symptom at least in part to the virus [10-12]. Again, those studies included mostly men, and one study [10] included only people over age 50. Furthermore, there may be differences between men and women in the causal attribution of symptoms that affect treatment decisions. A study on sex/gender differences found that women reported having more neuropathic symptoms, and consequently reducing and discontinuing DDI – a substance with the potential of inducing neuropathic symptoms – more frequently than men [13].

Several studies indicated sex-related differences in side effects of ART, encompassing symptoms such as lipodystrophy, neuropathy, and skin rashes, as well as laboratory abnormalities of liver enzymes, lipid profiles, insulin resistance, and lactic AV-951 acidosis [14-17]. Surprisingly, none of those studies examined gender differences in the patients’ causal attributions of those symptoms. Understanding causal attributions of symptoms of people with HIV and their gender differences may have important implications for HIV-treatment and management of side effects of ART.