A Qualitative Study of Patient Motivation to Adhere to Combination Antiretroviral Therapy in South Africa

Loggerenberg, Francois van; Gray, Denis Pereira; Gengiah, Santhanalakshmi; Kunene, Pinky; Gengiah, Tanuja N.; Naidoo, Kogieleum; Grant, Alison D.

doi:10.1089/apc.2014.0293

Cited by 41 publications

(46 citation statements)

References 47 publications

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“…Previous studies have shown that positive attitudes towards ART and the immediate effect of gaining strength upon taking ART facilitated patients’ adherence and further reinforced their desire to live long and healthy (Kumarasamy et al, 2005; Loggerenberg et al, 2015; Penn, Watermeyer, & Evans, 2011; Reda & Biadgilign, 2012; Watt et al, 2009). We found that other motivators such as disease control, preventing infections or TB was moderately ranked and similarly valued among those with and without current partners.…”

Section: Discussionmentioning

confidence: 99%

“…Motivational interviewing or counseling among PLWH has been used as an important tool to emphasize individual health benefits of ART and to encourage comprehensive HIV prevention (Hill & Kavookjian, 2012; Safren et al, 2001, 2009). Qualitative studies have shown that individuals who perceive the benefits of ART as “life-giving” and providing better overall health tend to have higher adherence (Kumarasamy et al, 2005; Loggerenberg et al, 2015). Partners also play an important role in determining ART initiation or retention in care but such influence may differ by partner’s HIV status (Morton et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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The effect of partner HIV status on motivation to take antiretroviral and isoniazid preventive therapies: a conjoint analysis

et al. 2018

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Antiretroviral therapy (ART) and isoniazid preventive therapy (IPT) are important to reduce morbidity and mortality among people newly diagnosed of HIV. The successful uptake of ART and IPT requires a comprehensive understanding of patients’ motivation to take such therapies. Partners also play an important role in the decision to be initiated and retained in care. We quantified patients’ motivation to take preventive therapies (ART and IPT) and compared by partner HIV status among people newly diagnosed of HIV. We enrolled and surveyed adults (≥18 years) with a recent HIV diagnosis (<6 months) from 14 public primary care clinics in Matlosana, South Africa. Participants received eight forced-choice tasks comparing two mutually exclusive sub-sets of seven possible benefits related to preventive therapies. A linear probability model was fitted to estimate the probability of prioritizing each benefit. Tests of concordance were conducted across partner HIV status (no partner, HIV− or unknown, or HIV+). A total of 424 people completed surveys. At the time of interview, 272 (64%) were on ART and 334 (79%) had a partner or spouse. Keeping themselves healthy for their family was the most important motivator to take preventive therapies (p < 0.001). Preventing HIV transmission to partners was also highly prioritized among participants with current partners independent of partner’s HIV status (p < 0.001), but it was least prioritized among those without current partners (p = 0.72). Keeping themselves healthy was less prioritized. We demonstrate that social responsibility such as supporting family and preventing HIV transmission to partners may pose greater motivation for ART and IPT initiation and adherence compared to individual health benefits. These messages should be emphasized to provide effective patient-centered care and counseling.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of partner HIV status on motivation to take antiretroviral and isoniazid preventive therapies: a conjoint analysis

et al. 2018

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“…They adhered to the treatment and were aware of the consequencies of failure to adhere to their HIV treatment. Participants reported proper adherence despite the challenges as reported in other studies (van Loggerenberg et al, 2015). They were also informed that this wasn't HIV treatment but rather minimised the effects of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…Similar knowledge in Somalia remain abstract because of the civil strife and unrest that has brought continuos fragility in the country, particularly in Mogadishu region. Despite the drafting of the national HIV strategy, Somalia still faces challenges of low coverage of HIV services with low capacity for monitoring and evaluation, poor supply of food and medicines in addition to the insecurity (UNAIDS, 2015).…”

Section: Introductionmentioning

confidence: 99%

Access to HIV Care and Resilience in a Long Term Conflict Setting. A Pilot Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

Kulane¹,

Owuor²,

Sematimba³

et al. 2017

Preprint

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Background: Human Immnodeficiency virus (HIV) continues to take a heavy toll on the lives of many people with worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region unexpressed. This pilot qualitative study sought to explore the experiences of people living with diagnosed HIV in Mogadishu and their resilience in access to care and social support. Method: Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving Antiretroviral therapy (ART) from the HIV clinic in Mogadishu. Participants were recruited through drug dispensers at the HIV clinic in Benader Hospital. These were tape recorded, transcribed and translated for content analysis. Results: Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouces or through health care contamination. They were very knowledgable about the realities of HIV, how the medication works, nutritional requirements and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organisations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainity of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants’ coping mechansms included living together and starting their own NGO for support with very strong optimism about their prognosis. Conclusions: The people living with diagnosed HIV in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with diagnosed HIV infection and efficacy of HIV treatment. Our small sample suggests adequate access to ART through NGOs. However, widespread HIV stigma limits HIV status disclosure to the families and communities which creates a risk of self isolation and ill health. But affected individuals have developed resilient mechanisms of managing the risks. They strive to remain employed for economic security, adhere to HIV treatment, engage in support groups and maintain utmost optimism about their prognosis.

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“…With the shift to the so-called "post-AIDS era" (Dowsett & McInnes, 1996) -an allusion to HIV becoming a chronic condition thanks to the availability of ARVs and the development of more effective diagnostic tools for monitoring HIV, such as the viral load test -the topic of HIV biomarkers and their relation to a person's everyday experience with HIV has proven to be of considerable academic interest (see Persson, 2004;Persson & Newman, 2006;Sangaramoorthy, 2012;Newman et al, 2015;van Loggerenberg et al, 2015). This article seeks to build on this research by interrogating the popular technology of an advice column as a platform for self-help and undertaking health.…”

Section: Introductionmentioning

confidence: 99%

HIV advice in the media: Implications for reinventing subjectivity

Nkomo

Long

2017

PINS

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A Qualitative Study of Patient Motivation to Adhere to Combination Antiretroviral Therapy in South Africa

Cited by 41 publications

References 47 publications

The effect of partner HIV status on motivation to take antiretroviral and isoniazid preventive therapies: a conjoint analysis

The effect of partner HIV status on motivation to take antiretroviral and isoniazid preventive therapies: a conjoint analysis

Access to HIV Care and Resilience in a Long Term Conflict Setting. A Pilot Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

HIV advice in the media: Implications for reinventing subjectivity

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