Abstract
To design effective, tailored interventions to support antiretroviral therapy (ART) adherence, a thorough understanding of the barriers and facilitators of ART adherence is required. Factors at the individual and interpersonal level, ART treatment characteristics and health care factors have been proposed as important adherence determinants.
Methods
To identify the most relevant determinants of adherence in northern Tanzania, in-depth interviews were carried out with 61 treatment-experienced patients from four different clinics. The interviews were ad-verbatim transcribed and recurrent themes were coded.
Results
Coding results showed that the majority of patients had basic understanding of adherence, but also revealed misconceptions about taking medication after alcohol use. Adherence motivating beliefs were the perception of improved health and the desire to live like others, as well as the desire to be a good parent. A de-motivating belief was that stopping ART after being prayed for was an act of faith. Facilitators of adherence were support from friends and family, and assistance of home based care (HBC) providers. Important barriers to ART adherence were the use of alcohol, unavailability of food, stigma and disclosure concerns, and the clinics dispensing too few pills. Strategies recommended by the patients to improve adherence included better Care and Treatment Centre (CTC) services, recruitment of patients to become Home Based Care ( HBC) providers, and addressing the problem of stigma through education.
Conclusion
This study underscores the importance of designing tailored, patient-centered adherence interventions to address challenges at the patient, family, community and health care level.
| Original language | English |
|---|---|
| Article number | 716 |
| Number of pages | 8 |
| Journal | BMC Public Health |
| Volume | 12 |
| DOIs | |
| Publication status | Published - 30 Aug 2012 |
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Keywords
- adolescent
- adult
- anti-HIV agents
- female
- HIV infections
- health knowledge, attitudes, practice
- humans
- interviews as topic
- male
- medication adherence
- middle aged
- motivation
- social support
- Tanzania
- young adult
Cite this
Determinants of antiretroviral therapy adherence in northern Tanzania : a comprehensive picture from the patient perspective. / Lyimo, Ramsey A; de Bruin, Marijn; van den Boogaard, Jossy; Hospers, Harm J; van der Ven, André; Mushi, Declare.
In: BMC Public Health, Vol. 12, 716, 30.08.2012.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Determinants of antiretroviral therapy adherence in northern Tanzania
T2 - a comprehensive picture from the patient perspective
AU - Lyimo, Ramsey A
AU - de Bruin, Marijn
AU - van den Boogaard, Jossy
AU - Hospers, Harm J
AU - van der Ven, André
AU - Mushi, Declare
PY - 2012/8/30
Y1 - 2012/8/30
N2 - BackgroundTo design effective, tailored interventions to support antiretroviral therapy (ART) adherence, a thorough understanding of the barriers and facilitators of ART adherence is required. Factors at the individual and interpersonal level, ART treatment characteristics and health care factors have been proposed as important adherence determinants.MethodsTo identify the most relevant determinants of adherence in northern Tanzania, in-depth interviews were carried out with 61 treatment-experienced patients from four different clinics. The interviews were ad-verbatim transcribed and recurrent themes were coded.ResultsCoding results showed that the majority of patients had basic understanding of adherence, but also revealed misconceptions about taking medication after alcohol use. Adherence motivating beliefs were the perception of improved health and the desire to live like others, as well as the desire to be a good parent. A de-motivating belief was that stopping ART after being prayed for was an act of faith. Facilitators of adherence were support from friends and family, and assistance of home based care (HBC) providers. Important barriers to ART adherence were the use of alcohol, unavailability of food, stigma and disclosure concerns, and the clinics dispensing too few pills. Strategies recommended by the patients to improve adherence included better Care and Treatment Centre (CTC) services, recruitment of patients to become Home Based Care ( HBC) providers, and addressing the problem of stigma through education.ConclusionThis study underscores the importance of designing tailored, patient-centered adherence interventions to address challenges at the patient, family, community and health care level.
AB - BackgroundTo design effective, tailored interventions to support antiretroviral therapy (ART) adherence, a thorough understanding of the barriers and facilitators of ART adherence is required. Factors at the individual and interpersonal level, ART treatment characteristics and health care factors have been proposed as important adherence determinants.MethodsTo identify the most relevant determinants of adherence in northern Tanzania, in-depth interviews were carried out with 61 treatment-experienced patients from four different clinics. The interviews were ad-verbatim transcribed and recurrent themes were coded.ResultsCoding results showed that the majority of patients had basic understanding of adherence, but also revealed misconceptions about taking medication after alcohol use. Adherence motivating beliefs were the perception of improved health and the desire to live like others, as well as the desire to be a good parent. A de-motivating belief was that stopping ART after being prayed for was an act of faith. Facilitators of adherence were support from friends and family, and assistance of home based care (HBC) providers. Important barriers to ART adherence were the use of alcohol, unavailability of food, stigma and disclosure concerns, and the clinics dispensing too few pills. Strategies recommended by the patients to improve adherence included better Care and Treatment Centre (CTC) services, recruitment of patients to become Home Based Care ( HBC) providers, and addressing the problem of stigma through education.ConclusionThis study underscores the importance of designing tailored, patient-centered adherence interventions to address challenges at the patient, family, community and health care level.
KW - adolescent
KW - adult
KW - anti-HIV agents
KW - female
KW - HIV infections
KW - health knowledge, attitudes, practice
KW - humans
KW - interviews as topic
KW - male
KW - medication adherence
KW - middle aged
KW - motivation
KW - social support
KW - Tanzania
KW - young adult
U2 - 10.1186/1471-2458-12-716
DO - 10.1186/1471-2458-12-716
M3 - Article
C2 - 22935331
VL - 12
JO - BMC Public Health
JF - BMC Public Health
SN - 1471-2458
M1 - 716
ER -