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

Abstract

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.

A phenomenological study of the beliefs of family caregivers of children living with HIV/AIDS on adherence to antiretroviral therapy

“…Some participants, however, stated that if one does not adhere strictly to the ART the viral load will increase and lead to early death. Similar findings have been made by Van Zyl et al (2017) and Raberahona et al (2019), whose responents indicated that taking ART is effective and will suppress HIV. On the contrary, Glendinning et al (2019) in a qualitative study to identify barriers to adherence to ART found that participants did not adhere to ART with the reason that the medicine could not cure and that they will still die from the disease and they believe that not doing well with HIV management is as a result of inadequate belief in God that does not guarantee to heal.…”

“…On the contrary, Glendinning et al (2019) in a qualitative study to identify barriers to adherence to ART found that participants did not adhere to ART with the reason that the medicine could not cure and that they will still die from the disease and they believe that not doing well with HIV management is as a result of inadequate belief in God that does not guarantee to heal. The participants of Raberahona et al (2019) further indicated that nonadherence or missing doses of ART will lead to the ineffectiveness of the medicine. Participants' belief in the positive and negative consequences of adherence and non‐adherence to ART respectively is a positive determinant for adherence.…”

“…The participants of Raberahona et al (2019) Some participants of this study expressed their belief that HIV/ AIDS is not a spiritual disease but bloodborne, and for that matter, should be treated with ARTs. They however added that prayers are needed to make the therapy effective.…”

Time to Antiretroviral Therapy Initiation and Its Predictors Among Newly Diagnosed HIV-Positive People in Nekemte Town, Western Ethiopia: Claim of Universal Test and Treat

“…This might be because disclosing one's own sero-status may enable the HIV-infected individual to get economic and social support from relatives; minimize HIV-related stigma which directly or indirectly encourages the patient to commence ART as early as possible and to adhere to the lifelong therapy and medical advice. 42,43 Likewise, individuals who attended educational level up to the level of college and above initiated ART earlier than those who could write and read only. Education enables people to understand the positive outcome of lifelong therapy; increases the selfconfidence to take decisions and change negative attitudes towards people living with HIV; educated people are more sociable, accept advice and direction that is provided by health providers as compared with those who are illiterate; 44,45 another study result reported that among HIVinfected individuals who initiated ART, 82.8% were literate while the rest were illiterate.…”

Cognitive-behavioural factors associated with adherence to antiretroviral medication among HIV infected patients in Ibadan, Oyo state

“…This result contradict that of Raberahona et al where the perception level of the participant in their study was good. 20 The result of this study further revealed that more than half 159 (55.2%) of the respondents had negative perceived susceptibility, 200 (69.5%) had negative perceived benefits and 149 (51.6%) had negative perceived barrier. More than half of the respondents 160 (55.6%) had positive perceived severity 160 (55.6%) and 165 (57.3%) has positive perceived self-efficacy.…”