Antiretroviral Treatment Knowledge and Stigma—Implications for Programs and HIV Treatment Interventions in Rural Tanzanian Populations

Agnarson, Abela Mpobela; Levira, Francis; Masanja, Honorati; Ekström, Anna Mia; Thorson, Anna

doi:10.1371/journal.pone.0053993

Cited by 9 publications

(7 citation statements)

References 29 publications

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“…This is encouraging for the future, as retention of HIV‐infected patients in the ART programme is essential to improving the long‐term outcomes of the patients. In the last 3 years, the improvement in the services at the health facility levels include more patient information, shorter waiting times, improved skills in attending HIV‐infected patients and other factors within the health facilities . Also with time, stigma against HIV is waning, and community awareness is increasing .…”

Section: Discussionmentioning

confidence: 99%

Improvement in mortality and retention among adult HIV‐infected patients in the first 12 months of antiretroviral therapy in Dodoma urban district,Tanzania.

Tweve

Kayabu

Nassari³

et al. 2015

Tropical Med Int Health

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Abstractobjective To determine mortality and retention in ART programmes in Tanzania, between 2010 and 2013.methods Retrospective routinely collected data were analysed from people starting ART in the period 2010-2013. Mortality and retention over the first 12 months on ART were compared across the 4 years, and adjustment was made for individual level potential confounders. conclusion Mortality and retention in the first 12 months on ART have significantly improved over the 4 years from 2010 to 2013. These improvements may indicate better services, earlier initiation on ART, and strengthened systems to provide ART in Tanzania. These results refute the worries that earlier initiation on ART might lead to lower retention in the ART programme.

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Section: Discussionmentioning

confidence: 99%

Improvement in mortality and retention among adult HIV‐infected patients in the first 12 months of antiretroviral therapy in Dodoma urban district,Tanzania.

Tweve

Kayabu

Nassari³

et al. 2015

Tropical Med Int Health

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“…We carried out a review of the existing literature to develop and adapt a questionnaire assessing the knowledge, attitude and practice of ART in PLHIV as no standardized and validated questionnaire is available [10, 16, 19, 24–28] (Additional file 1).…”

Section: Methodsmentioning

confidence: 99%

Knowledge, attitudes, perception and practices regarding antiretroviral therapy among HIV-infected adults in Antananarivo, Madagascar: a cross-sectional survey

Raberahona¹,

Lidamahasolo

Andriamamonjisoa

et al. 2019

BMC Health Serv Res

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Background Adherence to antiretroviral therapy (ART) may be influenced by knowledge, perception and perception regarding ART. The purpose of this study was to assess knowledge, attitude/perception and practice regarding ART among people living with HIV/AIDS (PLHIV). Methods We conducted a cross-sectional survey to assess knowledge, attitudes, perception and practices ART in PLHIV. The survey was suggested to all PLHIV of at least 18 years old and who were on ART for at least 1 month. PLHIV who were unable to answer questions correctly and those who did not complete the survey for any reason were excluded. Results During the study period, 234 PLHIV were included. Participants were mostly men (75.2%). The median age was 33 years (IQR: 27–41). The median time since HIV diagnosis was 25 months (IQR: 9–56) and the median duration of ART was 18 months (IQR: 8–48). 87.6% had an overall good knowledge of ART. However, only 3.2% knew the name of their ART, 31.2% were aware that ART should be taken at a fixed time and 17.1% knew how to take ART in relation to food intake. 75.6% of participants had an overall positive attitude/perception of ART. However, 10.7% were convinced that other methods were more effective than ART for treating HIV and 42.7% thought that taking ART was shameful. The assessment of practices showed that in case of missed dose, 48.3% of participants routinely skipped this dose instead of trying to take it as soon as possible. In multivariate analysis, good knowledge of ART was independently associated with high level of education (aOR: 4.7, IC95%: 1.6–13.7, p = 0.004) and disclosure of HIV status (aOR: 2.7, IC95%: 1.1–6.6, p = 0.029). Conclusions This study showed an overall good knowledge and a predominantly positive attitude/perception of ART. However, accurate knowledge of ART intake was insufficient and the stigma associated with taking ART remained very present. Furthermore, very heterogeneous practices may reflect lack of instruction given by the physician regarding ART intake. Electronic supplementary material The online version of this article (10.1186/s12913-019-4173-3) contains supplementary material, which is available to authorized users.

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“…Majority of infected return migrants did not report return home for care or treatment as their main reason for migration in an attempt to hide their HIV. This was mainly contributed by high stigma behaviour in the study area toward HIV positive individuals and ARV users ( 39 , 40 ). Men's superiority behavior observed elsewhere may also influence some of the male respondents not to report return home for care or treatment in an effort to maintain their status quo ( 39 – 41 ).…”

Section: Discussionmentioning

confidence: 99%

“…This was mainly contributed by high stigma behaviour in the study area toward HIV positive individuals and ARV users ( 39 , 40 ). Men's superiority behavior observed elsewhere may also influence some of the male respondents not to report return home for care or treatment in an effort to maintain their status quo ( 39 – 41 ). Following widespread availability of ART, diseased individuals reporting ‘follow parents’ decreased from 50 to 34%.…”

Section: Discussionmentioning

confidence: 99%

Coming home to die? The association between migration and mortality in rural Tanzania before and after ART scale-up

Levira

Todd

Masanja

2014

Global Health Action

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BackgroundPrior to the scale-up of antiretroviral therapy (ART), demographic surveillance cohort studies showed higher mortality among migrants than residents in many rural areas.ObjectivesThis study quantifies the overall and AIDS-specific mortality between migrants and residents prior to ART, during ART scale-up, and after widespread availability of ART in Rufiji district in Tanzania.DesignIn Health and Demographic Surveillance System (HDSS), the follow-up of individuals aged 15–59 years was categorized into three periods: before ART (1998–2003), during ART scale-up (2004–2007), and after widespread availability of ART (2008–2011). Residents were those who never migrated within and beyond HDSS, internal migrants were those who moved within the HDSS, and external migrants were those who moved into the HDSS from outside. Mortality rates were estimated from deaths and person-years of observations calculated in each time period. Hazard ratios were estimated to compare mortality between migrants and residents. AIDS deaths were identified from verbal autopsy, and the odds ratio of dying from AIDS between migrants and residents was estimated using the multivariate logistic regression model.ResultsInternal and external migrants experienced higher overall mortality than residents before the introduction of ART. After widespread availability of ART overall mortality were similar for internal and external migrants. These overall mortality experiences observed were similar for males and females. In the multivariate logistic regression model, adjusting for age, sex, education, and social economic status, internal migrants had similar likelihood of dying from AIDS as residents (adjusted odds ratio [AOR]=1.14, 95% confidence interval [CI]: 0.70–1.87) while external migrants were 70% more likely to die from AIDS compared to residents prior to the introduction of ART (AOR=1.70, 95% CI: 1.06–2.73). After widespread availability of ART with the same adjustment factors, the odds of dying from AIDS were similar for internal migrants and residents (AOR=1.56, 95% CI: 0.80–3.04) and external migrants and residents (AOR=1.42, 95% CI: 0.76–2.66).ConclusionsAvailability of ART has reduced the number of HIV-infected migrants who would otherwise return home to die. This has reduced the burden on rural communities who had cared for the return external migrants.

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Antiretroviral Treatment Knowledge and Stigma—Implications for Programs and HIV Treatment Interventions in Rural Tanzanian Populations

Cited by 9 publications

References 29 publications

Improvement in mortality and retention among adult HIV‐infected patients in the first 12 months of antiretroviral therapy in Dodoma urban district,Tanzania.

Improvement in mortality and retention among adult HIV‐infected patients in the first 12 months of antiretroviral therapy in Dodoma urban district,Tanzania.

Knowledge, attitudes, perception and practices regarding antiretroviral therapy among HIV-infected adults in Antananarivo, Madagascar: a cross-sectional survey

Coming home to die? The association between migration and mortality in rural Tanzania before and after ART scale-up

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