scholarly journals Barriers to adherence to antiretroviral treatment in a regional hospital in Vredenburg, Western Cape, South Africa

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Ivo N. Azia ◽  
Ferdinand C. Mukumbang ◽  
Brian Van Wyk
Keyword(s):  
South Africa ◽  
Antiretroviral Treatment ◽  
Mother Tongue ◽  
Regional Hospital ◽  
People Living With Hiv ◽  
Western Cape ◽  
Semistructured Interview ◽  
Qualitative Research Design ◽  
Study Participants ◽  
Living With Hiv

Background: South Africa currently runs the largest public antiretroviral treatment (ART) programme in the world, with over 80% of people living with HIV and/or AIDS on ART. However, in order to appreciate the benefits of using ART, patients are subject to uncompromising and long-term commitments of taking at least 95% of their treatment as prescribed. Evidence shows that this level of adherence is seldom achieved because of a multilevel and sometimes interwoven myriad of factors.Objective: We described the challenges faced by patients on ART in Vredenburg with regard to ART adherence.Methods: A descriptive qualitative research design was used. Eighteen non-adhering patients on ART in the Vredenburg regional hospital were purposefully selected. Using a semistructured interview guide, we conducted in-depth interviews with the study participants in their mother tongue (Afrikaans). The interviews were audio-taped, transcribed verbatim and translated into English. The data were analysed manually using the thematic content analysis method.Results: Stigma, disclosure, unemployment, lack of transport, insufficient feeding, disability grants and alternative forms of therapy were identified as major barriers to adherence, whereas inadequate follow-ups and lack of patient confidentiality came under major criticisms from the patients.Conclusion: Interventions to address poverty, stigma, discrimination and disclosure should be integrated with group-based ART adherence models in Vredenburg while further quantitative investigations should be carried out to quantify the extent to which these factors impede adherence in the community.

Motivating people living with HIV to initiate antiretroviral treatment outside national guidelines in three clinics in the HPTN 071 (PopART) trial, South Africa

2021 ◽  
Vol 20 (1) ◽  
pp. 32-41
Author(s):  
Constance Mubekapi-Musadaidzwa ◽  
Dillon Wademan ◽  
Neshaan Peton ◽  
Portia Hendricks ◽  
Gabriela Carolus ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Treatment ◽  
People Living With Hiv ◽  
National Guidelines ◽  
Living With Hiv

Stigma and disclosure as barriers to regular dental care for people living with HIV/AIDS in Kwazulu-Natal and Western Cape, South Africa

2014 ◽  
Vol 7 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Mervyn Turton ◽  
Sudeshni Naidoo
Keyword(s):  
South Africa ◽  
Health Care ◽  
Oral Health ◽  
Oral Health Care ◽  
People Living With Hiv ◽  
Western Cape ◽  
Content Type ◽  
Stigma And Discrimination ◽  
Health Care Experiences ◽  
Living With Hiv

Purpose – The purpose of this paper is to determine the oral health care experiences of people living with HIV in Kwazulu-Natal (KZN) and the Western Cape (WC) and also to identify the role of stigma and discrimination in the oral health care experiences for people living with HIV in KZN and the WC. Design/methodology/approach – This study was a survey among HIV-positive people attending selected Community Health Centres and regional hospitals, HIV clinics in KZN and WC provinces in South Africa. The sample consisted of people living with HIV that were 18 years or older and who had given written, informed consent. A cross-sectional study structure has been employed using a standardized format using a semi-structured interview and an administered questionnaire to collect data. The study classified participants as living in metropolitan or non-metropolitan areas. Findings – Apprehension of loss of confidentiality, stigma and discrimination were the barriers that deterred participants from seeking care. Respondents stated that they feared what the dentist and staff would think of them being HIV positive and feared being discriminated against by the dentist and staff. In some instances there appears to be a difference between policy and practice regarding the oral health care needs of and services rendered to people living with HIV in public health facilities as there are still patients who do not obtain care and for whom the attitudes of the health care provider constitutes the major barrier to accessing that care. Research limitations/implications – The results are specific to KZN and WC and have to be extrapolated with caution to the rest of South Africa. Additionally, this study did not have a control group of HIV-negative people which would have enabled one to determine whether certain barriers were unique to people living with HIV. Practical implications – To make recommendations with respect to addressing the issue of stigma and discrimination in the oral health care experiences for people living with HIV in KZN and the WC as there is a definite need for the government to address the resource needs of rural areas and less developed areas of South Africa. Health care is a much-needed resource in these high prevalence areas and governments must ensure that all their HIV/AIDS projects and policies should have a rural component built into them. Social implications – This study emphasizes the importance of embracing people that are being discriminated and marginalized by society such as people living with HIV to ensure that they feel a franchised member of society who can take the initiative to be in control of their own health and, with the necessary aid from public resources and societal support, join forces to reduce the public health burden and its impact on the socio-economic milieu. Originality/value – To the best of the author's knowledge, there is no other study that has compared differences in the use of oral health care services by people with HIV in South Africa and these results serve as an indication of some the important issues in this regard.

scholarly journals Quantifying clinic transfers among people living with HIV in the Western Cape, South Africa: a retrospective spatial analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055712
Author(s):  
Ana Lucia Espinosa Dice ◽  
Angela M Bengtson ◽  
Kevin M Mwenda ◽  
Christopher J Colvin ◽  
Mark N Lurie
Keyword(s):  
South Africa ◽  
Spatial Analysis ◽  
Health Facilities ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Western Cape ◽  
Western Cape Province ◽  
Care Clinic ◽  
Living With Hiv ◽  
Over Time

ObjectivesFor persons living with HIV (PLWH) in long-term care, clinic transfers are common and influence sustained engagement in HIV care, as they are associated with significant time out-of-care, low CD4 count, and unsuppressed viral load on re-entry. Despite the geospatial nature of clinic transfers, there exist limited data on the geospatial trends of clinic transfers to guide intervention development. In this study, we investigate the geospatial characteristics and trends of clinic transfers among PLWH on antiretroviral therapy (ART) in the Western Cape Province of South Africa.DesignRetrospective spatial analysis.SettingPLWH who initiated ART treatment between 2012 and 2016 in South Africa’s Western Cape Province were followed from ART initiation to their last visit prior to 2017. Deidentified electronic medical records from all public clinical, pharmacy, and laboratory visits in the Western Cape were linked across space and time using a unique patient identifier number.Participants4176 ART initiators in South Africa (68% women).MethodsWe defined a clinic transfer as any switch between health facilities that occurred on different days and measured the distance between facilities using geodesic distance. We constructed network flow maps to evaluate geospatial trends in clinic transfers over time, both for individuals’ first transfer and overall.ResultsTwo-thirds of ART initiators transferred health facilities at least once during follow-up. Median distance between all clinic transfer origins and destinations among participants was 8.6 km. Participant transfers were heavily clustered around Cape Town. There was a positive association between time on ART and clinic transfer distance, both among participants’ first transfers and overall.ConclusionThis study is among the first to examine geospatial trends in clinic transfers over time among PLWH. Our results make clear that clinic transfers are common and can cluster in urban areas, necessitating better integrated health information systems and HIV care.

scholarly journals Oral health care experiences of people living with HIV in Kwazulu-Natal and Western Cape, South Africa

2015 ◽  
Vol 8 (2) ◽  
pp. 59-69
Author(s):  
Mervyn Turton ◽  
Sudeshni Naidoo
Keyword(s):  
South Africa ◽  
Health Care ◽  
Oral Health ◽  
Dental Care ◽  
Oral Health Care ◽  
People Living With Hiv ◽  
Western Cape ◽  
Content Type ◽  
Living With Hiv ◽  
To Receive

Purpose – The purpose of this paper is to ascertain the oral health experiences of people living with HIV/AIDS in the provinces of Kwazulu-Natal (KZN) and Western Cape (WC) in South Africa. Many studies have reported that people living with HIV have unmet needs for dental care and this study considered the various factors that affect the accessibility and utilisation of dental services as these factors are even more pertinent for the people living with HIV who have increased need for dental care. Design/methodology/approach – The participants were selected among HIV-positive people attending selected Community Health Centre and regional hospital HIV clinics in KZN and WC provinces. The sample consisted of people living with HIV that were 18 years or older and who had given written, informed consent. The sample (n=435) comprised mainly of black females in the age group 20-29 years. In total, 347 participants (79.8 per cent) had an oral health problem of which 83 per cent (n=288) received care. Findings – Of those that received care, 56.6 per cent (n=163) of the participants stated that the staff were aware of their HIV status. Almost a third of the participants who received care reported a negative experience at the clinic. If the participant lived in a metropolitan area, the participant was 3.647 times more likely to receive care than if the participant lived in a non-metropolitan area (p < 0.01) If the participant earned R5,000 or less, the participant was 0.106 times less likely to receive care (p=0.048). If the participant lived 1-5 km from the clinic, the participant was 3.371 times more likely to receive care (p=0.015). Research limitations/implications – The results are specific to KZN and WC and cannot be extrapolated with caution to the rest of South Africa. However, to the best of the author’s knowledge, there is no other study that has compared differences in the use of oral health care services by people with HIV in South Africa and these results serve as an indication of some the important issues in this regard. Additionally, this study did not have a control group of HIV-negative people which would have enabled one to determine whether certain barriers were unique to people living with HIV. Practical implications – The study highlighted the barriers to care existing within the current public health system relative to the provision of oral health services for people living with HIV in KZN and WC. It was anticipated that by ascertaining the nature and extent of unmet needs and barriers to dental care for people living with HIV, measures can be put in place to remove or at least reduce the barriers to care and improve the quality of life for people living with HIV/AIDS in South African communities. Social implications – The high prevalence of oral health problems in people living with HIV makes it imperative for the DOH to make every attempt to remove barriers to oral health care and thereby secure equitable, affordable and accessible oral health care which is acceptable for people living with HIV and accountable to the greater society. Originality/value – This study emphasises the importance of embracing people that are being discriminated and marginalised by society such as people living with HIV to ensure that they feel a franchised member of society who can take the initiative to be in control of their own health and, with the necessary aid from public resources and societal support, join forces to reduce the public health burden and its impact on the socio-economic milieu.

Sign in / Sign up

Export Citation Format

Share Document