Determinants of antiretroviral therapy adherence in northern Tanzania

a comprehensive picture from the patient perspective

Ramsey A Lyimo, Marijn de Bruin, Jossy van den Boogaard, Harm J Hospers, André van der Ven, Declare Mushi

Research output: Contribution to journalArticle

32 Citations (Scopus)
4 Downloads (Pure)

Abstract

Background
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 languageEnglish
Article number716
Number of pages8
JournalBMC Public Health
Volume12
DOIs
Publication statusPublished - 30 Aug 2012

Fingerprint

Tanzania
Therapeutics
Home Care Services
Alcohols
Interviews
Community Health Services
Family Health
Disclosure
Patient Compliance
Patient Selection
Patient Care
Delivery of Health Care
Education
Food
Health

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 journalArticle

Lyimo, Ramsey A ; de Bruin, Marijn ; van den Boogaard, Jossy ; Hospers, Harm J ; van der Ven, André ; Mushi, Declare. / Determinants of antiretroviral therapy adherence in northern Tanzania : a comprehensive picture from the patient perspective. In: BMC Public Health. 2012 ; Vol. 12.
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