Antiretroviral therapy adherence strategies used by patients of a large HIV clinic in Lesotho

Abstract

A high degree of adherence to antiretroviral therapy (ART) in patients infected with human immunodeficiency virus (HIV) is necessary for long term treatment effects. This study explores the role of timing of ART intake, the information patients received from health workers, local adherence patterns, barriers to and facilitators of ART among 28 HIV-positive adults at the Senkatana HIV Clinic in Maseru, Lesotho. This qualitative, semi-structured interview study was carried out during February and March of 2011 and responses were analyzed inspired by the Grounded Theory method. Results were then compared and discussed between the authors and the main themes that emerged were categorized. The majority of the respondents reported having missed one or more doses of medicine in the past and it was a widespread belief among patients that they were required to skip the dose of ART if they were “late”. The main barriers to adherence were interruptions of daily routines or leaving the house without sufficient medicine. The use of mobile phone alarms, phone clocks and support from family and friends were major facilitators of adherence. None of the patients reported to have been counseled on family support or the use of mobile phones as helpful methods in maintaining or improving adherence to ART. Being on-time with ART was emphasized during counseling by health workers. In conclusion, patients should be advised to take the dose as soon as they remember instead of skipping the dose completely when they are late. Mobile phones and family support could be subjects to focus on during future counseling particularly with the growing numbers of mobile phones in Africa and the current focus on telemedicine.

Patient-reported barriers and facilitators to antiretroviral adherence in sub-Saharan Africa

“…Just over half of the qualitative studies conducted semi-structured in-depth interviews (IDIs) (49; 56.3%) [17,20–22,26,27,29,32–37,39–43,45–47,49,51,54–60,62,63,65–67,69–71,78,81,84,85,87–90,95–97,165] with their HIV-positive participants. Eighteen studies (20.7%) used focus group discussions (FDGs) [19,23–25,28,50,53,61,68,73,74,76,77,82,94,98,167,169], 16 used both IDIs and FDGs (18.4%) [18,30,31,38,44,52,64,72,75,79,83,86,92,93,99,170], one used free attitude interviews (FAIs) and FGDs (1.1%) [80], one used group sessions without more detail [168], one used IDIs and life history and illness narratives [48] and one used digital stories [91].…”

Individual, household, and community level barriers to ART adherence among women in rural Eswatini

“…Empirical studies across settings in sub-Saharan Africa indicate that ART adherence can be influenced by risk factors operating at multiple levels. At the individual level, ART adherence is associated with age, gender, educational level, forgetfulness, ART duration, alcohol use, stress, lack of money, and lack of disclosure status [17][18][19][20][21]. At the household level, ART adherence is associated with household food insecurity, household socioeconomic status, lack of family support, and use of traditional medicine [18,20,[22][23][24].…”

Vivências de jovens em terapia antirretroviral para o HIV: estudo fenomenológico

“…Os jovens se mantêm ocupados com os afazeres e as obrigações relacionadas a essa vivência e buscam estratégias para manter a rotina de tomar os remédios corretamente, o que está expresso nos depoimentos quando relatam que têm que tomar nas horas certas, independente dos efeitos colaterais. Tais estratégias também são apontadas em estudo realizado na África do Sul o qual mostra que o uso de alarmes de telefones celulares e o apoio de familiares e amigos foram facilitadores da adesão à terapia (23).…”