Antiretroviral therapy in Africa

Treating depression in HIV-positive patients affects adherence

“…Some researchers question the feasibility of the rapid scaling-up and sustainability of ART programmes in depressed people, 25,53 citing concerns about the low and suboptimal adherence in depressed patients leading to the development of resistant HIV strains. [54][55][56] Resistant strains may leave subsequently infected patients without effective treatment options 24 or require a change to second-line treatment regimens, which are ten times more expensive than first-line regimens.…”

Reasons for unsatisfactory acceptance of antiretroviral treatment in the urban Kibera slum, Kenya

“…Many misinterpret the death of family members on ART as caused by the medication rather than opportunistic infections/ AIDS. Coping with the initial side effects of ART requires a well-informed client, which is more challenging to achieve in contexts where illiteracy and lack of health staff is a reality (Stevens et al, 2004). Information about side effects was given by health workers and by handing out pamphlets that were copied from earlier ART-programmes in South Africa.…”

The Price of Adherence: Qualitative Findings From HIV Positive Individuals Purchasing Fixed-Dose Combination Generic HIV Antiretroviral Therapy in Kampala, Uganda

“…Early debates over public health responses to AIDS in sub-Saharan Africa assumed poor adherence to HIV antiretroviral (ARV) medications in impoverished countries (Stevens, Kaye, and Corrah, 2004). Recent studies, however, have measured antiretroviral adherence rates of over 90% in several southern African countries (Laurent et al, 2004;Orrell, Bangsberg, Badri, and Wood, 2003;Oyugi et al, 2004), including findings from our own group showing mean adherence rates of 91-94% in an urban Ugandan cohort purchasing self-administered, generic ARV therapy (Oyugi et al, 2004).…”