Factors Affecting Adherence to Highly Active Antiretroviral Therapy among Patients Attending Public Healthcare Facility

OBJECTIVE: To determine the clinical and demographic variables related to adherence to highly active antiretroviral therapy (HAART) in patients treated in our hospital and identify the characteristics of nonadherent patients. METHODS: Outpatients receiving treatment with HAART (n = 283) were asked about variables related to adherence and to complete the APGAR (family support), State-Trait Anxiety questionnaire (STAI) (emotional situation), and IAS (social support) questionnaires. Patients were classified in 2 groups depending on whether adherence was ≥95% or <95%. Adherence was defined as the percentage of dosage forms prescribed that were obtained by the patient at the hospital pharmacy. A multivariate analysis was created to analyze how each significant variable affected adherence. RESULTS: Our data showed significant nonadherence for patients with the following factors: low level of education, unemployed, emotional situation, and abuse of substances including intravenous drugs. All significant variables were included in a logistic regression model to optimize the results. This model considered 4 variables: age (95% CI 0.89 to 0.99), number of antiretroviral drugs (95% CI 1.05 to 2.11), STAI Anxiety/Trait test (95% CI 2.02 to 6.02), and abuse of drugs (95% CI 1.20 to 3.95). CONCLUSIONS: We recommended special intervention to reinforce adherence for younger patients, patients taking a high number of antiretroviral drugs, those who have a history of intravenous drug use, and those with high anxiety status.

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"I Visited a Traditional Healer Because I Felt I wasn’t Getting any Better by Using Active Antiretroviral". Understanding Cultural Imperatives in the Context of Adherence to Highly Active Antiretroviral Therapy

The Open Public Health Journal ◽

10.2174/1874944501912010315 ◽

2019 ◽

Vol 12 (1) ◽

pp. 315-320

Author(s):

Matombo Ondwela ◽

Tebogo Mothiba ◽

Nozuko Mangi ◽

Daniel Ter Goon

Keyword(s):

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Cultural Practices ◽

Limpopo Province ◽

Hiv Positive ◽

Factors Affecting ◽

Highly Active ◽

Traditional Health ◽

Cultural Orientations ◽

Health Practitioners

Background: Anecdotal and empirical evidence seems to indicate that many people across the African continent indulge in different cultural practices that impinge on their adherence to the Highly Active Antiretroviral Therapy (HAART). These cultural practices vary between ethnicities or regions. Objective: The aim of this paper was to explore the cultural practices affecting HIV positive patients’ adherence to HAART in the Mopani district in Limpopo province, South Africa. Methods: A qualitative, explorative, descriptive study was conducted. Data were collected through one-to-one unstructured interviews using an interview schedule guide. Data were analysed using Tesch’s method of qualitative data analysis. Results: The findings indicate that cultural practices and beliefs concerning diseases and cure, prevailing faith that traditional health practitioners (THPs) could treat HIV/AIDS, stigmatisation of HIV patients, and the belief that HIV is caused by witchcraft and demons were the factors affecting patients on HAART. Clearly, HIV positive patients on HAART concurrently visit and patronise the THPs. This practice is affected by their cultural orientations and negatively impact on their adherence to HAART. Conclusion: The increased patronage of traditional medicine among HIV individuals are HAART calls for the integration of traditional health services into public health, and a multi-disciplinary collaboration would be beneficial to the community.

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