ART Adherence as a Key Component of Prevention With Persons Living With HIV in Mozambique

Abstract

Medication adherence is an effective approach to prevent HIV transmission. In Mozambique, a country with a generalized epidemic, the government has adopted Positive Prevention (PP) training for clinicians as part of its national strategy. Our study, conducted after trainings in five clinics, examined the understanding of trained health care staff and their patients about the importance of adherence to antiretroviral therapy (ART), a key element of PP. Interviews with trained clinicians (n = 31) and patients (n = 57) were conducted and analyzed. Clinicians and patients demonstrated an understanding that ART adherence could decrease HIV transmission. However, participants also highlighted the difficulties of adherence when patients had limited access to food. At the same time that treatment as prevention awareness was increasing, poverty and widespread food insecurity were barriers to taking medications. In Mozambique, the full benefits of treatment as prevention may not be realized without adequate access to food.

Factors Influencing Non-Adherence to Antiretroviral Therapy Among HIV/AIDS Patients in Western Sumatra: Implications for Practice in the Post-COVID-19 Era

“…Before therapy is given, counseling must be given with the aim of increasing awareness about the prevention and treatment of HIV/AIDS, which must be taken in a disciplined manner and consumed throughout life [16]. If stopping therapy will hasten the death of people with HIV/AIDS [17], then adherence to antiretroviral treatment is important [18]. There is no single cause that causes nonadherence, while if patients comply, it will reduce HIV/AIDS transmission [19].…”

Ineffective health control: concept analysis

“…For PLWHA, their needs go beyond treating the disease and involve an entire emotional and social context that permeates the difficulties in dealing daily with situations such as depressive symptoms, stigma, discrimination, a reframing of their life history, in addition to adverse effects related to the therapeutic regimen. From the analysis, it was possible to identify five critical attributes (4) : patient's refusal to follow the therapeutic plan (7,(9)(10)13,21,(23)(24)(25)27,(31)(32)34,37,(40)(41)(45)(46)49,51) ; abandonment of treatment leading to ineffective results and worsening of symptoms (8,11,14,(16)(17)22,26,(28)(29)(35)(36)(38)(39)42,44,46,(48)(49)(50) ; difficulty in reaching goals agreed between the person and the health professional (6,12,15,(18)(19)(20)37,…”

Mental disorders and adherence to antiretroviral treatment in health facilities in Mozambique

“…The current UNAIDS 95-95-95 global effort to end the HIV epidemic by 2030 emphasizes that 95% of people with HIV know their status, 95% of those knowing their status have access to treatment, and 95% of those under treatment have suppressed viral load (7). Factors associated with poor adherence to ART in sub-Saharan countries include unavailability of health care services, stigma, and discrimination, mental health problems (e.g., hazardous alcohol use, depression), negligence to take medications, poor understanding of HIV illness, disbelief about HIV and its treatment, poverty, food insecurity, medication side effects, poor patient-provider relationships, and difficulty accessing health services (8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18).…”