What causes non-adherence among some individuals on long term antiretroviral therapy? Experiences of individuals with poor viral suppression in Uganda
| Autor: | Dominic Bukenya, Janet Seeley, Billy N. Mayanja, Sarah Nakamanya, Richard Muhumuza |
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| Rok vydání: | 2018 |
| Předmět: |
lcsh:Immunologic diseases. Allergy
0301 basic medicine Gerontology Adult Complementary Therapies Counseling Male Sustained Virologic Response 030106 microbiology Social Stigma Stigma (botany) HIV Infections Medication Adherence 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) Virology Antiretroviral Therapy Highly Active Medicine Humans Pharmacology (medical) Confidentiality Uganda 030212 general & internal medicine Longitudinal Studies Qualitative Research Travel business.industry Compensation (psychology) Research Social Support Long term ART Term (time) Antiretroviral therapy Regimen Cross-Sectional Studies Adherence Cohort Quality of Life Molecular Medicine Female Thematic analysis lcsh:RC581-607 business In-depth interviews |
| Zdroj: | AIDS Research and Therapy AIDS Research and Therapy, Vol 16, Iss 1, Pp 1-9 (2019) |
| ISSN: | 1742-6405 |
| Popis: | Background Antiretroviral therapy (ART) use by people living with HIV reduces HIV transmission, morbidity, mortality, and improves quality of life. Good ART adherence is required to achieve these benefits. We investigated how the environmental, social, economic and behavioural experiences of people living with HIV with poor viral suppression could explain their non-adherence to long term ART. Methods This qualitative cross-sectional study was conducted in Uganda between September 2015 and April 2016. Thirty individuals on ART for 5 years or more (10 on first line and 20 on second line), with poor viral suppression, were randomly selected from a cohort of people living with HIV on ART. In-depth interviews about ART; awareness, adherence counselling, obstacles to daily adherence and regimen switches were conducted. Emerging themes from the interviews transcripts and field notes were identified and thematic content analysis done. Participants’ consent, compensation, confidentiality and study ethical approvals were ensured. Results We found that poor adherence to long term ART was due to: travel for work or social activities, stigma, receiving little or no continuous ART adherence education, alcohol consumption and use of alternative ‘HIV cure’ medicines. Other reasons included; ART side effects, treatment fatigue, belief that long-term ART or God can ‘cure HIV’, and food security. Conclusions Achieving optimal ART benefits requires continuous provision of ART adherence education to individuals on long term ART. This helps them overcome the challenges related to living with HIV: worries of food insecurity, alcohol misuse, economic hardship, and beliefs in HIV cures and use of unproven alternative HIV treatments. People living with HIV who travel require adherence support and larger quantities of ART refills to cover their time away. |
| Databáze: | OpenAIRE |
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