Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Phillip J. Brantley


Nonadherence to medical regimens is a critical behavioral threat to the health of HIV-infected individuals. Patients cannot benefit from increasingly efficacious treatments for HIV/AIDs unless they adhere to them. Consistent medical care plays a central role in prolonging life and enhancing quality of life for these individuals. It is therefore essential to understand why many patients do not return reliably for medical services. However, little research has focused on the development of empirically based models of HIV-related nonadherence. Thus, the primary purpose of the present study was to identify factors predictive of HIV-related nonadherence to medical appointments. Demographic, medical care, and psychosocial factors were identified that prospectively predicted percentage of scheduled HIV clinic appointments no-showed by outpatients. The results of this study indicated that greater nonadherence to outpatient appointments was associated with younger age, minority background, less severe illness, and lower perceived social support. Individuals from minority backgrounds and younger age groups were found to have higher rates of nonadherence to HIV treatment demands. Nonadherence was also demonstrated to be problematic early in the disease course. From the perspective of potential psychosocial interventions, it was particularly interesting that higher levels of perceived social support were associated with less outpatient visit nonadherence. Practical and theoretical implications of these findings are discussed in light of recent medical advances.