Inhibited interpersonal coping style predicts poorer adherence to scheduled clinic visits in human immunodeficiency virus infected women at risk for cervical cancer

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Abstract
Background: One of the most common gynecologic conditions among HIV+ women is cervical dysplasia, the precancerous phase of cervical cancer. Therefore, adherence to gynecology vi sits may be among the most important health care practices for HIV+ women. However, no research has evaluated the psychosocial factors associated with health care practices among HIV+ women at risk for cervical cancer.Purpose: This study examined the relationship between inhibited interpersonal coping style and adherence to primary care and obstetrics/gynecology visits in HIV+ women with Human Papillomavirus (HPV) infection.Methods: Twenty-eight HIV-1 seropositive Black, non-Hispanic women underwent a psychosocial interview, blood draw, and gynecologic examination. The Millon Behavioral Health Inventory was used to assess coping style. Medical chart review was used to assess adherence to scheduled special immunology clinic visits for 24 months following study entry.Results: Results suggested that greater inhibited coping style significantly predicted greater nonadherence to clinic visits during 1-year (β = .45, p = .04) and 2-year (β =.58, p = .02) follow-up, even after controlling for the possible confounding effects of recent depressed mood on adherence. Social support satisfaction did not mediate the relationship between inhibited coping style and nonadherence.Conclusions: These findings suggest that interpersonal coping style assessment may be a useful tool in predicting adherence in HIV+ women with HPV. Future research should assess the effect of psychosocial interventions on coping style, adherence, and cervical dysplasia in HIV+ women with HPV.