Hunger, waiting time and transport costs: Time to confront challenges to ART adherence in Africa

Hardon, Anita; Akurut, D; Comoro, C.; Ekezie, C; Irunde, Henry; Gerrits, Trudie; Kglatwane, J; Kinsman, John; Kwasa, R; Maridadi, J; Moroka, Tirelo Modie; Moyo, Sikhulile; Nakiyemba, Alice; Nsimba, Stephen E. D.; Ogenyi, R; Oyabba, T; Temu, Florence; Laing, Richard

doi:10.1080/09540120701244943

Cited by 439 publications

(456 citation statements)

References 19 publications

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“…Patients cannot aff ord to travel far, especially when such travel expends 1 or more working days every month. 59 Long waiting times and frequent stock-outs do not support adherence. Public health systems need holistic patientcentred care with appointment systems, evening opening hours, and task-shifting and down-referral of chronic treatment to rural facilities close to home.…”

Section: Integrate Pharmaceutical Management Of Ncds With Existing Inmentioning

confidence: 99%

Promotion of access to essential medicines for non-communicable diseases: practical implications of the UN political declaration

et al. 2013

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Section: Integrate Pharmaceutical Management Of Ncds With Existing Inmentioning

confidence: 99%

Promotion of access to essential medicines for non-communicable diseases: practical implications of the UN political declaration

et al. 2013

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“…However, most health facilities did not provide nutritional support to their patients on ART. Lack of food has been identified before in some studies as a factor responsible for patients defaulting from their treatments (Hardon et al, 2007;Nachega et al, 2006).…”

Section: Nutritional Supportmentioning

confidence: 99%

“…However, among the 37 qualitative studies included in the review, only two were from developing countries, thus the authors concluded that 'Research is urgently needed to determine patient-important factors for adherence in developing world settings. ' Several reports have been published since then from qualitative studies exploring factors that may affect adherence to ART (Hardon, Akurut, Comoro, Ekezie, Irunde & Gerrits et al, 2007;Kumarasamy, Safren, Raminani, Pickard, James, Krishnan et al, 2005;Malta, Petersen, Clair, Freitas & Bastos, 2005;Nachega, Knowlton, Deluca, Schoeman, Waltkinson, Efron et al, 2006). In an open cohort study of more than 16 000 adult patients that were started on ART in urban Zambia (Lusaka), poor adherence was among the factors found to be strongly correlated with mortality (Stringer, Zulu, Levy, Stinger, Mwango, Chi et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to patients' adherence to antiretroviral treatment in Zambia: a qualitative study

Sanjobo

Frich

Fretheim

2008

SAHARA-J: Journal of Social Aspects of HIV/AIDS

133

135

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Patients' adherence to antiretroviral therapy (ART) is important for effective medical treatment of HIV/AIDS. We conducted a qualitative interview study in the Copperbelt Province of Zambia in 2006. The aim of the study was to explore patients' and health care professionals' perceived barriers and facilitators to patients' adherence to ART. Based on data from individual interviews and focus group interviews with a total of 60 patients and 12 health care professionals, we identified barriers and facilitators related to patients' beliefs and behaviours, the health service, and socio-economic and cultural factors. Among the barriers we identified were lack of communication and information about ART, inadequate time during consultations, lack of follow-up and counselling, forgetfulness, stigma, discrimination and disclosure of HIV status, lack of confidentiality in the treatment centres, and lack of nutritional support.Feeling better, prospects of living longer, family support, information about ART, support for income-generating activities, disclosure of HIV status, prayers and transport support were among the facilitators. Our study suggests that several issues need to be considered when providing ART. Further research is needed to study interactions between patients and their health care providers. Our findings can inform interventions to improve adherence to ART.

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“…These strategies have mainly been evaluated in high-income countries. Most adherence studies in Africa have focused on home-based support, building self-efficacy and assessing ART costs and adherence (Diabate, Alary, & Koffi, 2007;Hardon et al, 2007;Mukherjee, Ivers, Leandre, Farmer, & Behforouz, 2006;Ramadhani et al, 2007;Simoni et al, 2008;Weidle et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Perceived stigma among patients receiving antiretroviral treatment: A prospective randomised trial comparing an m-DOT strategy with standard-of- care in Kenya

Kaai

Bullock

Sarna³

et al. 2010

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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HIV and AIDS remain highly stigmatised. Modified directly observed therapy (m-DOT) supports antiretroviral treatment (ART) adherence but little is known about its association with perceived stigma in resource-constrained settings. In 2003, 234 HIV-infected adults enrolled in a two-arm randomised trial comparing a health centre-based m-DOT strategy with standard self-administration of ART. Data on perceived stigma were collected using Berger's HIV stigma scale prior to starting ART and after 12 months. This was a secondary analysis to examine whether perceived stigma was related to treatment delivery. Perceived stigma scores declined after 12 months of treatment from a mean of 44.9 (sd=7.6) to a mean of 41.4 (sd=7.7), (t=6.14, P<0.001). No differences were found between the mean scores of participants in both study arms. Also, no difference in scores was detected using GLM, controlling for socio-demographic characteristics and baseline scores. Findings indicate that a well managed clinic-based m-DOT does not increase perceived HIV-related stigma.

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Hunger, waiting time and transport costs: Time to confront challenges to ART adherence in Africa

Cited by 439 publications

References 19 publications

Promotion of access to essential medicines for non-communicable diseases: practical implications of the UN political declaration

Promotion of access to essential medicines for non-communicable diseases: practical implications of the UN political declaration

Barriers and facilitators to patients' adherence to antiretroviral treatment in Zambia: a qualitative study

Perceived stigma among patients receiving antiretroviral treatment: A prospective randomised trial comparing an m-DOT strategy with standard-of- care in Kenya

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