Barriers to HIV Treatment Adherence: A Qualitative Study of Discrepancies Between Perceptions of Patients and Health Providers in Tanzania and Uganda
| Autor: | Tamara Nsubuga-Nyombi, Jude Ssensamba, Amy F Stern, Anisa Ismail, Canice Ahearn, Monica M Ngonyani, Jane Mvungi, Corrina Moucheraud |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Counseling
Male Health Knowledge Attitudes Practice Social Stigma 8.1 Organisation and delivery of services HIV Infections Tanzania 0302 clinical medicine health behavior 7.1 Individual care needs Health care Medicine Uganda 030212 general & internal medicine Hiv treatment Qualitative Research media_common Practice biology Health Knowledge Health Services Influencer marketing Infectious Diseases Anti-Retroviral Agents Pill Public Health and Health Services Social ecological model HIV/AIDS Female 0305 other medical science Infection Attitude to Health Health and social care services research Adult medicine.medical_specialty Attitude of Health Personnel media_common.quotation_subject Health Personnel antiretroviral therapy Medication Adherence Interviews as Topic 03 medical and health sciences Clinical Research Perception Virology Behavioral and Social Science Humans Poverty Motivation 030505 public health business.industry Prevention Public Health Environmental and Occupational Health Social Support biology.organism_classification Good Health and Well Being Behavioral and Psychosocial Research Family medicine Attitudes Management of diseases and conditions business Qualitative research |
| Zdroj: | AIDS Patient Care STDS AIDS patient care and STDs, vol 33, iss 9 |
| Popis: | Previous qualitative studies about antiretroviral therapy (ART) adherence have largely focused on patient experiences. Less is known about the perspective of health care providers-particularly in low-income countries-who serve as gatekeepers and influencers of patients' HIV care experiences. This study explored patients' and providers' perceptions of important ART adherence determinants. Interviews were conducted at HIV treatment sites in Tanzania and Uganda, with adult patients on ART (n = 148), and with health care providers (n = 49). Patients were asked about their experiences with ART adherence, and providers were asked about their perceptions of what adherence challenges are faced by their patients. All interviews were conducted in local languages; transcripts were translated into English and analyzed using a codebook informed by the social ecological model. Themes were examined across and within countries. Adherence-related challenges were frequently reported, but patients and providers did not often agree about the reasons. Many patients cited challenges related to being away from home and therefore away from their pill supply; and, in Uganda, challenges picking up refills (access to care) and related to food sufficiency/diet. Providers also identified these access to care barriers, but otherwise focused on different key determinants (e.g., they rarely mentioned food/diet); instead, providers were more likely to mention alcohol/alcoholism, stigma, and lack of understanding about the importance of adhering. These findings suggest areas of opportunity for future research and for improving clinical care by aligning perceptions of adherence challenges, to deliver better-informed and useful ART counseling and support. |
| Databáze: | OpenAIRE |
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