Abstract
BackgroundThe importance of dedicated adherence to antiretroviral treatment (ART) in the management of Human Immunodeficiency Virus (HIV) is well documented. Multiple factors may affect adherence and this study explores patients’ and their caregivers’ perceptions of factors which may positively influence adherence to ART.MethodThis study was a descriptive, qualitative study that used both free attitude interviews and focus-group discussions. Nineteen patients attending a busy ART-clinic at a district hospital in KwaZulu-Natal and eight caregivers were purposefully selected. Selection criteria included good adherence to ARTs as evidenced by excellent clinic attendance for more than one year with evidence of clinical, immunological and viral improvement. Interviews were tape recorded, transcribed and thematically analysed.ResultsTen female participants, nine male participants and eight caregivers took part in the study. Participants highlighted three main categories that positively affect their adherence to ART namely: patient, disease and health care provider-related factors. Sub-themes included issues related to acceptance, disclosure to significant others, symptomatic improvement on ARTs and the importance of supportive relationships. Participants greatly valued the health care provider relationship and felt that the main role of the health care provider was to educate and support.ConclusionThis study has shown that the factors which most influenced adherence were patient-related (acceptance, disclosure, determination, and family support), disease-related and treatment-related (symptomatic illness and improvement on ARTs), and healthcare worker-related (relationships, and adherence classes).
Highlights
SettingAntiretroviral treatment (ART) has changed Human Immunodeficiency Virus (HIV) infection from a fatal disease to a chronic illness which can be managed much like other chronic illness.[1]
Two focus group discussions (FGD) were conducted in patientshomes with family members in an attempt to overcome any potential bias created by conducting interviews in the hospital environment and to obtain the opinion of caregivers on factors promoting adherence to antiretroviral treatment (ART)
Two of the patients selected did not participate in the FGDs; one women excused herself on the day of the interview and one man arrived too late to participate
Summary
SettingAntiretroviral treatment (ART) has changed Human Immunodeficiency Virus (HIV) infection from a fatal disease to a chronic illness which can be managed much like other chronic illness.[1]. A meta-analysis of 21 African studies carried out in 2006 showed that 77% of 12 116 HIV positive patients had adherence rates of 95% to ART.[6] A Tanzanian study conducted in 2009, demonstrated that adherence was related to the level of trust between the patient and the health care provider, this relationship was not considered to be a major factor affecting adherence in other studies.[7] Other factors that were considered important for adherence were:. The importance of dedicated adherence to antiretroviral treatment (ART) in the management of Human Immunodeficiency Virus (HIV) is well documented. Multiple factors may affect adherence and this study explores patients’ and their caregivers’ perceptions of factors which may positively influence adherence to ART
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