Abstract
ABSTRACTBackground: This study aimed to understand the relevance of treatment supporters in adherence among people living with HIV taking Anti-retroviral therapy (ART) for more than five years in Uganda. Methods: In-depth interviews were conducted with 50 participants (28 women and 22 men) of the Complications of Long-Term ART (CoLTART) cohort with experience of at least five years on ART in Uganda. Participants were stratified by line of ART regimen and viral loads of less or above 1000 copies/ml. Data were analyzed thematically. Results: Many participants felt that a treatment supporter was most useful at the beginning of therapy before individuals get used to the drugs or when they are still weak. However, this did not reflect treatment outcomes, as many individuals without treatment supporters had failed on first line ART regimens and were switched to second line ART. Those who were still on first line had viral loads of ≥1000 copies/ml. There was a preference for female treatment supporters, many of who were persistent in their supportive role. Conclusion: Treatment supporters remain important in adherence to long-term ART. HIV-care providers need to encourage the involvement of a treatment supporter for individuals taking ART long-term.
Highlights
This study aimed to understand the relevance of treatment supporters in adherence among people living with HIV taking Antiretroviral therapy (ART) for more than five years in Uganda
The introduction of antiretroviral therapy (ART) into HIV care and treatment, has restored health to many people living with HIV (PLHIV)(Gusdal et al, 2011; Igumbor, Scheepers, Ebrahim, Jason, & Grimwood, 2011; Joint United Nations Programme on HIV/AIDS, 2016)
In this paper, drawing on qualitative data, we investigate the role of treatment supporters in sustaining adherence for people living with HIV on long-term ART
Summary
This study aimed to understand the relevance of treatment supporters in adherence among people living with HIV taking Antiretroviral therapy (ART) for more than five years in Uganda. Results: Many participants felt that a treatment supporter was most useful at the beginning of therapy before individuals get used to the drugs or when they are still weak This did not reflect treatment outcomes, as many individuals without treatment supporters had failed on first line ART regimens and were switched to second line ART. Those who were still on first line had viral loads of ≥1000 copies/ml. In 2013, it was reported that the scaling up of ART had averted an estimated 4.2 million deaths in low- and middle-income countries within a period of a decade (World Health Organisation, 2013) All these ARTrelated benefits are dependent on good adherence (Loutfy et al, 2013; Mayanja et al, 2013; Robbins, Spector, Mellins, & Remien, 2014).
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