Background: Self-efficacy and medication beliefs are known factors that influence adherence to treatment in chronic medical conditions. We carried out a cross-sectional study on human immunodeficiency virus (HIV)-infected patients with the aim of determining the predictive relationship between these two variables and adherence to antiretroviral therapy (ART) at a health facility in Pretoria. Method: Participants' medication beliefs were assessed using the Beliefs about Medicines Questionnaire. Self-efficacy was evaluated using the HIV Adherence Self-Efficacy Scale, and adherence to ART determined using the AIDS Clinical Trial Group questionnaire. Results:The mean age of the 232 participants was 40 years (standard deviation 15.6). Seventy per cent were females. Most had been on ART for over two years (87%), and 81.5% were adherent to at least 95% of the prescribed antiretroviral drugs. Nonadherence was highest in those on ART for more than three years (63%). The mean HIV Adherence Self-Efficacy score was 6.45 out of a possible 10. Beliefs held by the participants about the importance of (necessity) and concerns about ART in the management of HIV infection were generally positive. There was a mean score of 4.05 out of 5, indicating a strong belief in the use of ART. There was a strong association between adherence self-efficacy and ART adherence (p < 0.001) in the nonadherent participants. Regression analysis showed significance for adherence self-efficacy on ART nonadherence (p < 0.041), with adherence self-efficacy explaining 9.8% of the variance. Conclusion: Patients' adherence self-efficacy explained a significant portion of variation in the nonadherence to ART, which suggests that low adherence self-efficacy is influential in ART nonadherence. Interventions aimed at improving adherence to ART should address adherence self-efficacy.

BackgroundAdherence in chronic disease conditions is described as the extent to which a person‘s behaviour corresponds to the prescribed medical advice of the healthcare provider. This is not limited to medication intake only but also includes acts such as following instructions regarding dietary or fluid restrictions and taking medicines at the prescribed times and intervals. Although adherence to antiretroviral therapy (ART) is a predictor of good clinical outcome among HIV-infected persons on ART, it is a major challenge and strict adherence is not very common. This article aims to examine the application and relevance of some cognitive-behavioural theories in antiretroviral therapy adherenceMethodsAfter doing a thorough literature review, contemporary theories of health behaviour at the individual and interpersonal levels referred to as cognitive-behavioural theories were explored. This review highlights some aspects of the cognitive perspective of health behaviour theories as a good theoretical framework that could be used for organising thoughts about adherence and other health behaviours among patients on lifelong treatment such as ART.ResultsKey concepts of these theories stipulate that behaviour is mediated by cognition i.e. knowledge and attitude affect the person’s action. In addition, cognitive-behavioural theories recognise knowledge alone as being insufficient to produce behavioural change; a person’s perception, motivation, skills and social environment are all influential in the process of behavioural change.ConclusionPrediction of medication adherence is complex, and health-related knowledge and beliefs alone are insufficient to achieve behaviour change, especially in chronic conditions such as HIV/AIDS. However, people can control or influence the events affecting their lives by integrating cognitive, social, and behavioural sub-skills related to beliefs of personal efficacy in performing these skills.

Abstractobjective To identify the reasons for presentation of sexual assault more than 72 h after the incidents at Newcastle Hospital, South Africa. results Overall, 219 (41%) of the victims presented at the hospital more than 72 h after the alleged sexual assault, mainly for fear of the perpetrator (37.4%). Females constituted 87%, and rape with vaginal penetration was the most common form of sexual assault reported (74%). Tests of significance showed a positive association between fear of the perpetrator and delayed presentation at hospital. Age under 9 years and being scared of what relatives would say about alleged sexual assault were also associated with delayed presentation.conclusions Attention needs to be focused on educating society on the importance of reporting sexual assault incidents promptly in order for victims to benefit from appropriate medical treatment.keywords sexual assault, delayed presentation, fear of perpetrator, post-exposure prophylaxis

The introduction of antiretroviral therapy (ART) in the management of HIV infection has resulted in a significant reduction in the morbidity and mortality associated with the disease. The fact that a nearly perfect adherence is required in ART has remained a major challenge to people infected with HIV. This review underscores the impact of adherence to antiretroviral therapy and highlights recent advances in adherence monitoring and enhancement among people infected with HIV who are on lifelong antiretroviral therapy.

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