Understanding adherence in virally suppressed and unsuppressed human immunodeficiency virus-positive urban patients on second-line antiretroviral treatment.

Autor: Gumede SB; Ezintsha, a sub-division of Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.; Department of Interdisciplinary Social Science, Public Health, Utrecht University, Utrecht, The Netherlands., Venter WDF; Ezintsha, a sub-division of Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa., Lalla-Edward ST; Ezintsha, a sub-division of Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.
Jazyk: angličtina
Zdroj: Southern African journal of HIV medicine [South Afr J HIV Med] 2020 Aug 11; Vol. 21 (1), pp. 1107. Date of Electronic Publication: 2020 Aug 11 (Print Publication: 2020).
DOI: 10.4102/sajhivmed.v21i1.1107
Abstrakt: Background: Understanding antiretroviral therapy (ART) adherence may assist in designing effective support interventions.
Objectives: This study elicited perspectives on how to promote treatment adherence from virologically suppressed and unsuppressed patients receiving second-line ART.
Methods: This was a cross-sectional study conducted with randomly selected patients active on second-line ART, from five public health facilities in the Johannesburg inner city. Data were collected on demographics, clinical information, participant's experiences and ART knowledge. Virological failure was defined as exceeding 1000 copies/mL.
Results: The study sample comprised 149 participants; of which 47.7% ( n = 71) were virally unsuppressed and 69.1% ( n = 103) were women; the median age of the participants was 42 years (interquartile range [IQR] 36-47 years). Experiencing medication-related difficulties in taking second-line ART ( p = 0.003), finding second-line regimen more difficult to take than a first-line regimen ( p = 0.001) and experiencing side effects ( p < 0.001) were all subjective predictors of virological failure. Participants' recommendations for improving adherence included the introduction of a single tablet regimen (31.6%, n = 55), reducing the dosage to once daily (26.4%, n = 46) and reducing the pill size for second-line regimen (4.0%, n = 7).
Conclusion: The results of this study highlight the importance of improving patients' knowledge about adherence and motivation to continue ART use despite the persistence of side effects and difficulties with taking medication.
Competing Interests: The authors declare that they have no competing interests.
(© 2020. The Authors.)
Databáze: MEDLINE
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