Abstract
Despite the roll out of free life prolonging HIV and AIDS drugs in many public clinics in Zambia and the well documented effects of Anti Retrovirals (ARVs) in reducing mortality among people living with HIV, some people living with HIV still abandon treatment. This study explores patient-related factors that influence adherence to the life prolonging drugs. It is hoped that such information would be useful in enhancing adherence so as to achieve the goal of ART. This information is critical considering irrefutable evidence that non-adherence to Anti-Retroviral Therapy (ART) can lead to drug resistance and consequently, transmission of drug resistant HIV. Drug resistant HIV is not only expensive to handle, but can lead to increased morbidity, mortality and increased incidence of HIV cases particularly, for a low income country like Zambia. Methods: This paper uses data from a large mixed method study which was conducted in a rural setting. The study explored how patient-related factors influence people living with HIV in continuing taking of medication. The paper, therefore, discusses the major reasons reported by HIV infected people on ART for either being able to consistently take their medication or failing to do so. Results: Both limiting and facilitating factors were identified as influencing adherence. Among the facilitators identified were one having a reminder, feeling better after being on ART, seeing someone on ART recover, desire to live longer and disclosure of one’s positive status. The limiting factors included forgetting to take medication, non-recovery while on treatment for some time and drug fatigue. A significant association was found between adherence treatment and one having a reminder, desire to live longer and seeing someone on ART get better. Conclusion: While facilitators enhanced adherence, the barriers prevented or discouraged people on ART from continuing taking AIDS medicines as prescribed by their health care providers. In order to avoid drug resistance and other public health implications, such as transmission of drug resistant HIV virus and deaths, there is need to address these patient-related barriers.
Highlights
Despite the roll out of free life prolonging HIV and AIDS drugs in many public clinics in Zambia and the well documented effects of Anti Retrovirals (ARVs) in reducing mortality among people living with HIV, some people living with HIV still abandon treatment
This study explores patient-related factors that influence adherence to the life prolonging drugs
Several studies from elsewhere and within the region have explored factors influencing adherence from the patient’s environment such as the health facility, community, structural and medicines. While some of these studies raise issues related to the way the health care system is organised, such as inadequacies in the health facility including shortage of staff, lack of confidentiality and trust among health care providers, distance to health care centres and related costs, long waiting times and stock outs of AIDS medicines to mention but a few [3] [4] [5] [6]
Summary
Several studies from elsewhere and within the region have explored factors influencing adherence from the patient’s environment such as the health facility, community, structural and medicines. While some of these studies raise issues related to the way the health care system is organised, such as inadequacies in the health facility including shortage of staff, lack of confidentiality and trust among health care providers, distance to health care centres and related costs, long waiting times and stock outs of AIDS medicines to mention but a few [3] [4] [5] [6]. Others focus on structural factors, poverty, livelihood insecurity and free provision of ARVs [7] [9]
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