Barriers and facilitators to antiretroviral therapy adherence among patients with HIV in Bissau, Guinea-Bissau: A qualitative study

Abstract

Adherence is a decisive factor in achieving a successful response to antiretroviral therapy (ART) for HIV infection. No previous studies have been conducted regarding HIV treatment adherence in Guinea-Bissau. In this study we assessed barriers and facilitators to patient ART adherence. Semi-structured interviews were conducted with 20 adult, HIV infected individuals receiving ART at a HIV treatment centre in Bissau, Guinea-Bissau. The grounded theory method was used to gather and analyse data. Results indicated that HIV-related knowledge was a determining factor for optimal adherence. The facilitators were experienced treatment benefits and complementing social networks. The barriers were treatment-related costs and competing livelihood needs; poor clinic infrastructure; perceived stigma; and traditional practices. Our findings indicate that good ART adherence, especially in resource-limited settings, requires that patients achieve adequate HIV-related knowledge. More studies on HIV-related knowledge and adherence among HIV infected individuals are currently needed.

Use of Non-Prescription Remedies by Ghanaian Human Immunodeficiency Virus-Positive Persons on Antiretroviral Therapy

“…In addition to non-adherence to ARV regimen, it has been previously argued that the use of non-prescription remedies may potentiate low retention in ART clinics (26). The authors identified among others, reasons for low retention in ART care to include the need to travel long distances to receive medication, and preference for faith and religious remedies over orthodox treatment (26, 27). In a descriptive cross-sectional study conducted in the Upper West Region of Ghana, patients’ suboptimal adherence to ART therapy was mainly attributed to shortage of drugs (42%) and side effects of ARVs (17%) (4).…”

“…The reasons attributed to low retention in ART care or clinics, for example, include financial cost, fear of stigmatization, the need to travel long distances to receive medication, food insecurity, lack of access to correct information, pill burden, and preference for faith and religious remedies compared to orthodox treatment (4, 26, 27). In a descriptive cross-sectional study conducted in the Upper West Region of Ghana, patients’ suboptimal adherence to ART therapy was mainly attributed to forgetfulness and shortage of drugs (4).…”

“…Only 17% of the patients missed taking their antiretroviral medications (ARVs) due to side effects (4). In Guinea-Bissau, Rasmussen et al identified HIV-related knowledge as the most important factor influencing adherence to ART (27). …”

Health Belief Model Dan Kaitannya Dengan Ketidakpatuhan Terapi Antireteroviral Pada Orang Dengan Hiv/Aids

“…Bahkan yang dirasakan adalah hal sebaliknya yaitu efek samping yang membuat informan utama tidak bertahan lama dalam menjalani terapi ARV. Hal ini sejalan dengan penelitian yang dilakukan oleh Rasmusen, et al (2013) bahwa aspek kemanfaatan terapi ARV yang dirasakan berdampak pada kepatuhan berobat pasien.…”

Nonadherence is Associated with Lack of HIV-Related Knowledge

“…This study showed that HIV-related knowledge was a determining factor for optimal adherence. 15 HIV-related knowledge may affect patient use, understanding, and utilization of health care information on HIV, hence limited health literacy is a known barrier to treatment adherence. 16 The aim of this cross-sectional study was to validate the findings of our previous study on barriers and facilitators to adherence and describe the association with HIV-related knowledge in Bissau, Guinea-Bissau.…”