A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland

Ahmed, Charisse; Jolly, Pauline E.; Padilla, Luz A.; Malinga, M; Harris, Chantal; Mthethwa, Nobuhle; Ba, Inessa; Styles, Amy; Perry, Sarah H.; Brooks, Raina D.; Naluyinda-Kitabire, Florence; Mamba, Makhosini; Preko, Peter

doi:10.2989/16085906.2017.1380677

Cited by 18 publications

(25 citation statements)

References 31 publications

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“…We found that as people's health improved on ART, some individuals moved to places far from their ART refill clinics in pursuit of work to earn an income that resulted in missed ART refill appointments. The missed ART refill appointments could be due to either busy work schedules, or lack of transport fares, as described by other studies; 21,22 and strongly suggested that committed and well-supported biological caregivers are a key determinant to ART adherence as these experienced a stronger connotation to promote adherence. 23 Medication-related factors indicated that children who were instantly started on ART after diagnosis were twice more likely to adhere than those started later.…”

Section: Discussionmentioning

confidence: 80%

<p>Differential Self-Reported Determinants to Antiretroviral Therapy Adherence: Findings from Caregivers of Children Under Five Years Living with Human Immunodeficiency Virus Infection Attending Al-Sabah Hospital, South Sudan</p>

Tong¹,

Atuhairwe²,

Taremwa³

2020

HIV

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This study explored the caregivers' self-reported determinants of antiretroviral therapy (ART) adherence among children under five years living with human immunodeficiency virus (HIV) infection attending Al-Sabah Hospital, South Sudan. Methods: A cross-sectional study of 126 caregivers of HIV-infected children under five years was conducted at Al-Sabah Hospital, South Sudan. Data were collected using an intervieweradministered questionnaire. The self-reported adherence was measured as a binary variable using binary logistic regression. Only variables that were significant at bivariate analysis were analyzed at multivariate level and interpreted using the odds ratios (p< 0.05). Results: Out of 126 caregivers with HIV-infected children, 38 (30.2%) did not adhere to ART. Of the proportion that adhered to ART (88, 69.8%), 49 (55.7%) were male. Most of the children (52, 59.1%) were above two years, but under five years. Fifty (56.8%) of those who adhered had completed 3 months on ART, and the majority were at WHO stage-1 of HIV infection. Analysis of the determinants indicated that children's duration on ART (p=0.001), type of ART regimen (single, double or triple therapy) (p=0.065), type of work done by the caregiver to earn a living (p-value 0.003), time a child was initiated on ART (p=0.002), caregiver-child relationship (p=0.002), caregiver-spousal support (p=0.019), type of support obtained whether monetary or not (p=0.000), when the child was started on ART (p=0.004), the person administering ART (p=0.010), the type of ARVs administered (p=0.001), the caregiver detecting ART side effects (p=0.000), types of adverse effects suffered by the child (p=0.043), time of receiving ART (p=0.047), use of western medicine (p=0.043), healthcare cadre (p=0.002), the kind of attention the healthcare provider offered (p=0.015), and improvements in quality of HIV services (p=0.001) were significantly associated with ART adherence. Conclusion: The study findings indicated that ART adherence among HIV-infected children under five years was suboptimal. This will necessitate continuous engagement and education of caregivers on the prominence of adhering to ART.

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Section: Discussionmentioning

confidence: 80%

<p>Differential Self-Reported Determinants to Antiretroviral Therapy Adherence: Findings from Caregivers of Children Under Five Years Living with Human Immunodeficiency Virus Infection Attending Al-Sabah Hospital, South Sudan</p>

Tong¹,

Atuhairwe²,

Taremwa³

2020

HIV

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“…This study uses a social ecological model (SEM) to explore how factors across multiple levels interact and influence ART adherence (Fig 1). The SEM is used in public health to understand the manner in which factors within multiple environmental domains exert an influence on individual health behaviors and outcomes [13,37,38].…”

Section: Methodsmentioning

confidence: 99%

Individual, household, and community level barriers to ART adherence among women in rural Eswatini

et al. 2020

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Background Despite access to free antiretroviral therapy (ART) for all people living with human immunodeficiency virus (HIV), noncompliance to treatment continues to be a significant challenge in Eswatini. Yet studies investigating barriers to ART adherence in Eswatini are scarce. Most notably, there is a lack of research regarding rural women in Eswatini, who are currently the country's most vulnerable to HIV infection. Therefore, the objective of the study is to investigate individual, household, and community level barriers to ART adherence among rural women living with HIV. Methods We conducted a qualitative study to investigate individual, household, and community level barriers to ART adherence. We conducted focus group discussions with HIV-infected women (n = 4) from rural villages in Eswatini, and in-depth interviews with healthcare workers (n = 8) serving the area clinics. Open and axial coding techniques were used for data analysis and interpreted within a social ecological framework. Results Our findings revealed several individual level barriers including hunger, side effects of ART, personal stress, lack of disclosure of HIV status, alcohol use, and forgetting to take ART. Lack of food, unemployment and scarcity of financial resources were identified as critical barriers at the household level. Community and institutional barriers encompassed factors related to health delivery such as lack of privacy, travel time, transportation costs, excessive alcohol use by healthcare workers, maltreatment, public and self-stigma, gossip, and long waits at clinics.

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“…A good proportion of women came only for delivery poorly followed (insufficient counseling, resistance to the screening test), in many small clinics in or out of the district with few information about the cascade PMTCT (Antenatal PMTCT and post-partum PMTCT). As Ahmed et al in a qualitative analysis, denial and guilt could be a reason of late initiation of ART among these pregnant women (Ahmed et al, 2017).…”

Section: Discussionmentioning

confidence: 83%

Lessons of the Prevention of the Mother to Child Transmission (PMTCT) of HIV in the Biyem-assi District Hospital FROM 2010 TO 2015

Maka¹

2018

TIJPH

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Introduction: Aids is a pandemic. In 2016, according to UNAIDS, the number of people living with HIV is 36.7 million. New infected children represent 160 000, mostly via their HIV positive mothers during pregnancy, delivery or breastfeeding. Since 2010, different political decisions were adopted and later the option B+ to reduce the transmission rate. Little is known about their implementation at the operational level in the Center Region of Cameroon. Method: We aimed to draw the evolution of PMTCT services in the Biyem-Assi District Hospital.

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A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland

Cited by 18 publications

References 31 publications

<p>Differential Self-Reported Determinants to Antiretroviral Therapy Adherence: Findings from Caregivers of Children Under Five Years Living with Human Immunodeficiency Virus Infection Attending Al-Sabah Hospital, South Sudan</p>

<p>Differential Self-Reported Determinants to Antiretroviral Therapy Adherence: Findings from Caregivers of Children Under Five Years Living with Human Immunodeficiency Virus Infection Attending Al-Sabah Hospital, South Sudan</p>

Individual, household, and community level barriers to ART adherence among women in rural Eswatini

Lessons of the Prevention of the Mother to Child Transmission (PMTCT) of HIV in the Biyem-assi District Hospital FROM 2010 TO 2015

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